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General NPI Number Information
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NPI Number | 1609947068
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Entity Type | Organization
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Legal Business Name | MICHAEL BAKER PHARMACY, INC.
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 02/14/2020
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Provider Practice Location Address
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Address Line | 101 W. MAIN ST.
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City | MARSHALL
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State | AR
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Zip | 72650
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Country | US
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Telephone | 870-448-3336
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Fax | 870-448-3335
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Provider Business Mailing Address
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Address Line | PO BOX 278
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City | MARSHALL
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State | AR
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Zip | 72650
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Country | US
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Telephone | 870-448-3336
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Fax | 870-448-3335
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Authorized Official
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Title or Position | OWNER, CEO
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Name | MICHAEL A BACKER
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Credential | P.D.
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Telephone | 870-448-3336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | AR20229
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State |
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