Healthcare Provider Details

I. General information

NPI: 1467693754
Provider Name (Legal Business Name): W P MALONE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2009
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 S 13TH ST SUITE B
ROGERS AR
72758-4204
US

IV. Provider business mailing address

PO BOX 524
ARKADELPHIA AR
71923-0524
US

V. Phone/Fax

Practice location:
  • Phone: 479-621-0400
  • Fax: 479-621-7079
Mailing address:
  • Phone: 877-420-9400
  • Fax: 870-245-1790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberAR20603
License Number StateAR

VIII. Authorized Official

Name: KATHY KNIGHT
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 778-420-9400