Healthcare Provider Details

I. General information

NPI: 1548357734
Provider Name (Legal Business Name): ROBERTSONS NORTH HEIGHTS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2006
Last Update Date: 03/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 E 35TH ST
TEXARKANA AR
71854-2746
US

IV. Provider business mailing address

1201 E 35TH ST
TEXARKANA AR
71854-2746
US

V. Phone/Fax

Practice location:
  • Phone: 870-774-3666
  • Fax: 870-772-8062
Mailing address:
  • Phone: 870-774-3666
  • Fax: 870-772-8062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR06769
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MARTIN ROBERTSON
Title or Position: OWNER AND PHARMACIST
Credential: PD
Phone: 870-774-3666