Healthcare Provider Details

I. General information

NPI: 1255449831
Provider Name (Legal Business Name): FRUCHEY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W CAPITOL AVE # 101A REGIONS CENTER
LITTLE ROCK AR
72201-3436
US

IV. Provider business mailing address

400 W CAPITOL AVE STE 101A REGIONS CENTER
LITTLE ROCK AR
72201-3436
US

V. Phone/Fax

Practice location:
  • Phone: 501-374-2207
  • Fax: 501-374-2208
Mailing address:
  • Phone: 501-374-2207
  • Fax: 501-374-2208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR18409
License Number StateAR

VIII. Authorized Official

Name: WALTER FRUCHEY
Title or Position: OWNER
Credential: PHARMD
Phone: 501-374-2207