Healthcare Provider Details

I. General information

NPI: 1184714099
Provider Name (Legal Business Name): MARKS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 02/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 MAIN ST SUITE D
MELBOURNE AR
72556
US

IV. Provider business mailing address

PO BOX 430
MELBOURNE AR
72556-0430
US

V. Phone/Fax

Practice location:
  • Phone: 870-368-5355
  • Fax: 870-368-5356
Mailing address:
  • Phone: 870-368-5355
  • Fax: 870-368-5356

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 Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR19514
License Number StateAR

VIII. Authorized Official

Name: MARK HERRINGTON
Title or Position: OWNER
Credential: PD
Phone: 870-368-5355