Healthcare Provider Details

I. General information

NPI: 1275534513
Provider Name (Legal Business Name): CHAPEL PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 CAMDEN RD SUITE #1
PINE BLUFF AR
71603-8480
US

IV. Provider business mailing address

3800 CAMDEN RD SUITE #1
PINE BLUFF AR
71603-8480
US

V. Phone/Fax

Practice location:
  • Phone: 870-879-1490
  • Fax: 870-879-1920
Mailing address:
  • Phone: 870-879-1490
  • Fax: 870-879-1920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberAR20195
License Number StateAR

VIII. Authorized Official

Name: DR. MICHAEL A STOVER
Title or Position: OWNER
Credential: PHARM D.
Phone: 870-879-1490