Healthcare Provider Details

I. General information

NPI: 1619991767
Provider Name (Legal Business Name): NEA PHARMACEUTICALS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 W PARKER RD
JONESBORO AR
72404-9583
US

IV. Provider business mailing address

1109 W PARKER RD
JONESBORO AR
72404-9583
US

V. Phone/Fax

Practice location:
  • Phone: 870-935-6400
  • Fax: 870-935-4027
Mailing address:
  • Phone: 870-935-6400
  • Fax: 870-935-4027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR03802
License Number StateAR

VIII. Authorized Official

Name: MICHAEL A SOO
Title or Position: OWNER
Credential: RPH
Phone: 870-935-6400