Healthcare Provider Details

I. General information

NPI: 1417458829
Provider Name (Legal Business Name): PARAGON PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2018
Last Update Date: 02/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14524 CANTRELL RD STE 100A
LITTLE ROCK AR
72223-4700
US

IV. Provider business mailing address

5401 N PORTLAND AVE STE 260
OKLAHOMA CITY OK
73112-2082
US

V. Phone/Fax

Practice location:
  • Phone: 877-245-7344
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HUNTER HOGAN
Title or Position: OPERATIONS MANAGER
Credential: DPH
Phone: 405-418-2929