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General NPI Number Information
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NPI Number | 1023423423
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Entity Type | Organization
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Legal Business Name | MVP WARREN LLC
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Dates
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Enumeration Date | 06/24/2014
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 101 N MAIN ST
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City | WARREN
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State | AR
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Zip | 71671-2714
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Country | US
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Telephone | 870-226-3751
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Fax | 870-226-3752
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Provider Business Mailing Address
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Address Line | PO BOX 552
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City | LAKE VILLAGE
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State | AR
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Zip | 71653-0552
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Country | US
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Telephone | 870-265-2220
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Fax | 870-265-2226
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Authorized Official
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Title or Position | CO-OWNER
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Name | NIKKI HOOD
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Credential |
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Telephone | 870-265-2220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | AR06454
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License Number State | AR
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