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General NPI Number Information
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NPI Number | 1922620483
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Entity Type | Organization
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Legal Business Name | EAST ARKANSAS FAMILY HEALTH CENTER PHARMACY NO. 3, LLC
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Dates
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Enumeration Date | 05/07/2020
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Last Update Date | 09/01/2020
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Provider Practice Location Address
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Address Line | 406 S MILL ST
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City | MARVELL
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State | AR
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Zip | 72366-7236
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Country | US
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Telephone | 870-829-1168
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Fax | 870-829-1152
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Provider Business Mailing Address
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Address Line | 900 N 7TH ST
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-2001
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Country | US
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Telephone | 870-733-6341
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Fax | 870-394-9541
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Authorized Official
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Title or Position | CEO
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Name | DR. SUSAN WARD-JONES
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Credential | MD
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Telephone | 870-735-3842
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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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