Healthcare Provider Details

I. General information

NPI: 1326169152
Provider Name (Legal Business Name): NEWSOM FAMILY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 12/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9661 STRONG HWY
STRONG AR
71765-8801
US

IV. Provider business mailing address

PO BOX 731
STRONG AR
71765-0731
US

V. Phone/Fax

Practice location:
  • Phone: 870-797-2011
  • Fax:
Mailing address:
  • Phone: 870-797-2011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR10403
License Number StateAR

VIII. Authorized Official

Name: LEAH MOYER
Title or Position: MANAGER
Credential:
Phone: 870-797-2011