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General NPI Number Information
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NPI Number | 1508972167
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Entity Type | Organization
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Legal Business Name | MEDIC PHARMACY INC
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 5901 W 12TH ST
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City | LITTLE ROCK
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State | AR
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Zip | 72204-1608
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Country | US
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Telephone | 501-664-3907
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Fax | 501-664-4491
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Provider Business Mailing Address
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Address Line | 5901 W 12TH ST
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City | LITTLE ROCK
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State | AR
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Zip | 72204-1608
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Country | US
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Telephone | 501-664-3907
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Fax | 501-664-4491
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. MICHAEL B ROGERS
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Credential | PHARMD
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Telephone | 501-664-3907
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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 | AR20027
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License Number State | AR
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