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General NPI Number Information
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NPI Number | 1730460338
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Entity Type | Organization
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Legal Business Name | SOUTH ARKANSAS PHARMACY, INC
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Dates
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Enumeration Date | 09/09/2011
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Last Update Date | 12/31/2018
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Provider Practice Location Address
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Address Line | 600 SOUTH TIMBERLANE #101
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City | EL DORADO
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State | AR
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Zip | 71730
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Country | US
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Telephone | 870-639-3929
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Fax | 870-639-3930
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Provider Business Mailing Address
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Address Line | 600 SOUTH TIMBERLANE #101
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City | EL DORADO
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State | AR
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Zip | 71730
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Country | US
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Telephone | 870-639-3929
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Fax | 870-639-3930
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Authorized Official
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Title or Position | OWNER/PIC
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Name | AMY MARIE CYPHERS
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Credential | RPH
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Telephone | 870-639-3929
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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 | AR20663
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License Number State | AR
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