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General NPI Number Information
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NPI Number | 1235358011
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Entity Type | Organization
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Legal Business Name | MEDICAL ARTS PHARMACY
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1219 W MAIN ST
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City | WALNUT RIDGE
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State | AR
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Zip | 72476-1003
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Country | US
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Telephone | 870-886-6251
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Fax | 870-886-5560
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Provider Business Mailing Address
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Address Line | PO BOX 8 1219 W. MAIN
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City | WALNUT RIDGE
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State | AR
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Zip | 72476-0008
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Country | US
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Telephone | 870-886-6251
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Fax | 870-886-5560
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Authorized Official
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Title or Position | OWNER
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Name | DR. RALPH JOSEPH
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Credential | M.D.
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Telephone | 870-886-6251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | AR06404
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License Number State | AR
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