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General NPI Number Information
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NPI Number | 1376647594
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Entity Type | Organization
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Legal Business Name | ROSE DRUG OF DOVER, INC
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 417 UNION ST
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City | DARDANELLE
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State | AR
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Zip | 72834-3429
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Country | US
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Telephone | 479-229-4811
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Fax | 479-229-5871
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Provider Business Mailing Address
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Address Line | 417 UNION ST
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City | DARDANELLE
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State | AR
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Zip | 72834-3429
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Country | US
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Telephone | 479-229-4811
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Fax | 479-229-5871
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | MR. RICHARD L HARMON
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Credential | P.D.
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Telephone | 479-229-4811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | AR20230
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License Number State | AR
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