Healthcare Provider Details

I. General information

NPI: 1164366456
Provider Name (Legal Business Name): JASON ALLEN BENTLEY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 HIGHWAY 201 N
MOUNTAIN HOME AR
72653-3158
US

IV. Provider business mailing address

116 HIGHWAY 201 N
MOUNTAIN HOME AR
72653-3158
US

V. Phone/Fax

Practice location:
  • Phone: 870-424-4010
  • Fax:
Mailing address:
  • Phone: 870-424-4010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD12290
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: