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General NPI Number Information
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NPI Number | 1699542035
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Entity Type | Organization
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Legal Business Name | PHARMACY CARE OF BENTON, LLC
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Dates
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Enumeration Date | 12/06/2023
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 1016 W SOUTH ST STE 1
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City | BENTON
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State | AR
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Zip | 72015-4074
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Country | US
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Telephone | 501-315-5100
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Fax | 870-246-6616
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Provider Business Mailing Address
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Address Line | 518 CLAY ST
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City | ARKADELPHIA
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State | AR
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Zip | 71923-6024
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Country | US
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Telephone | 870-246-5553
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Fax | 870-246-6616
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM PERCY MALONE
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Credential | RPH
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Telephone | 870-246-5553
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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 |
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License Number State |
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