Healthcare Provider Details

I. General information

NPI: 1760470520
Provider Name (Legal Business Name): HEALTHCARE PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 01/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 ATWOOD RD SUITE F
LITTLE ROCK AR
72206-6012
US

IV. Provider business mailing address

3401 ATWOOD RD SUITE F
LITTLE ROCK AR
72206-6012
US

V. Phone/Fax

Practice location:
  • Phone: 501-888-7514
  • Fax: 501-888-7504
Mailing address:
  • Phone: 501-888-7514
  • Fax: 501-888-7504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. JERRY B STEPHENS
Title or Position: PRESIDENT
Credential: RPH
Phone: 501-888-7514