MEDICARE: MEDICAL PARK PHARMACY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336S0011X	Specialty Pharmacy
3	3336C0003X	Community/Retail Pharmacy	AR20264	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1992914	OTHER	PK
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558324624
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL PARK PHARMACY LLC

Provider Business Mailing Address
First Line	:	121 E. VANBUREN
Second Line	:	SUITE C
City	:	EUREKA SPRINGS
State	:	AR
Zip	:	72632
Country	:	US
Telephone Number	:	479-253-9751
Fax Number	:	479-253-7149

Provider Business Practice Location Address
First Line	:	121 E VAN BUREN STE C
Second Line	:
City	:	EUREKA SPRINGS
State	:	AR
Zip	:	72632-3658
Country	:	US
Telephone Number	:	479-253-9751
Fax Number	:	479-253-7149

Authorized Official
Title or Position	:	OWNER
Name	:	VADA MCCALLOUGH
Credential	:	RPH
Telephone Number	:	479-253-9751

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	03/27/2017

Similar Medicare Providers

1821090705 — DR. ALAN N RUCKET M.D.
Practice Location Address:

1005 IVY FALLS DR
SANDY SPRINGS, GA
30328-3658

Practice Phone: 404-255-1005
Practice Fax: 404-255-1184

1467613158 — DR. ADAM LEE KILKENNEY D.O.
Practice Location Address:

5625 N ACADEMY BLVD STE 1800
COLORADO SPRINGS, CO
80918-3658

Practice Phone: 719-599-0444
Practice Fax: 719-599-8809

1225272834 — COMPLETE FAITH PALLIATIVE HOSPICE CARE, INC
Practice Location Address:

14111 FREEWAY DRIVE , SUITE 318
SANTA FE SPRINGS, CA
90670-3658

Practice Phone: 562-319-9374
Practice Fax: 951-736-8996

1114223815 — DR. NATHAN E. HENRY PT, DPT, CSCS
Practice Location Address:

5643 N ACADEMY BLVD
COLORADO SPRINGS, CO
80918-3658

Practice Phone: 720-316-9974
Practice Fax: 720-294-0332

1093354938 — ANDREW SHORT DPT
Practice Location Address:

5643 N ACADEMY BLVD
COLORADO SPRINGS, CO
80918-3658

Practice Phone: 720-316-9974
Practice Fax: 720-294-0332

1861061483 — RACHAEL NACHTIGAL, PLLC
Practice Location Address:

716 S MAXWELL ST
SILOAM SPRINGS, AR
72761-3658

Practice Phone: 501-607-0436
Practice Fax: 479-439-8466

Directions to “MEDICAL PARK PHARMACY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.