Healthcare Provider Details

I. General information

NPI: 1669826954
Provider Name (Legal Business Name): CAEB INVESTMENTS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2016
Last Update Date: 01/29/2020
Certification Date: 01/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11200 ARCH STREET
LITTLE ROCK AR
72206
US

IV. Provider business mailing address

11200 ARCH STREET
LITTLE ROCK AR
72206
US

V. Phone/Fax

Practice location:
  • Phone: 501-261-7181
  • Fax: 501-475-0398
Mailing address:
  • Phone: 501-261-7181
  • Fax: 501-475-0398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberAR20749
License Number StateAR

VIII. Authorized Official

Name: CHARLIE JACK TUCKER
Title or Position: OWNER
Credential:
Phone: 501-261-7181