Healthcare Provider Details

I. General information

NPI: 1780681932
Provider Name (Legal Business Name): FUTRELL PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E BROADWAY ST
POCAHONTAS AR
72455-3402
US

IV. Provider business mailing address

115 E BROADWAY ST
POCAHONTAS AR
72455-3402
US

V. Phone/Fax

Practice location:
  • Phone: 870-892-5616
  • Fax: 870-892-2592
Mailing address:
  • Phone: 870-892-5616
  • Fax: 870-892-2592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number110305716
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number122010733
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberAR05743
License Number StateAR

VIII. Authorized Official

Name: DR. JEFFREY MARK FUTRELL
Title or Position: PRESIDENT & CEO
Credential: P.D.
Phone: 870-892-5615