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General NPI Number Information
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NPI Number | 1568678613
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Entity Type | Organization
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Legal Business Name | I CARE OF ARKANSAS, INC.
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1527 S BOWMAN RD SUITE D
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City | LITTLE ROCK
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State | AR
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Zip | 72211-4207
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Country | US
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Telephone | 501-687-0999
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Fax |
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Provider Business Mailing Address
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Address Line | 1527 S BOWMAN RD SUITE D
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City | LITTLE ROCK
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State | AR
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Zip | 72211-4207
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Country | US
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Telephone | 501-687-0999
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | GENE GRAVES
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Credential | PHARM D
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Telephone | 501-687-0999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | AR20396
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License Number State | AR
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