Healthcare Provider Details

I. General information

NPI: 1114291507
Provider Name (Legal Business Name): ARKANSAS FAMILY PHARMACIES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2012
Last Update Date: 03/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 E WALNUT ST
PARIS AR
72855-4125
US

IV. Provider business mailing address

1211 E WALNUT ST
PARIS AR
72855-4125
US

V. Phone/Fax

Practice location:
  • Phone: 479-963-6400
  • Fax: 479-963-2103
Mailing address:
  • Phone: 479-963-6400
  • Fax: 479-963-2103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateAR

VIII. Authorized Official

Name: MR. CHARLES EDWARD LEE
Title or Position: VICE PRESIDENT
Credential: P.D.
Phone: 479-774-5921