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General NPI Number Information
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NPI Number | 1487706925
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Entity Type | Organization
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Legal Business Name | MAM ENTERPRISES INC
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 04/12/2011
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Provider Practice Location Address
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Address Line | 11200 ARCH ST
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City | LITTLE ROCK
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State | AR
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Zip | 72206-4649
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Country | US
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Telephone | 501-261-7181
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Fax | 501-261-7307
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Provider Business Mailing Address
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Address Line | PO BOX 241250
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City | LITTLE ROCK
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State | AR
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Zip | 72223-0005
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Country | US
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Telephone | 501-261-7181
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Fax | 501-261-7307
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Authorized Official
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Title or Position | OWNER
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Name | MARK ALAN MCMURRY
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Credential | P.D.
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Telephone | 501-261-7181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | AR20275
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License Number State | AR
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