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NPI Code Detail

MEDICARE: CITY PHARMACY

MEDICARE: CITY PHARMACY
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
13336L0003XLong Term Care Pharmacy

General Provider Information

NPI Number : 1669032173
Entity Type Code : Organization
Provider Name (Legal Business Name) : CITY PHARMACY
Provider Business Mailing Address
First Line : 1801 BROADWAY ST
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72206-1222
Country : US
Telephone Number : 501-374-6565
Fax Number : 501-374-6231
Provider Business Practice Location Address
First Line : 1801 BROADWAY ST
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72206-1222
Country : US
Telephone Number : 501-374-6565
Fax Number : 501-374-6231
Authorized Official
Title or Position : OWNER
Name : ANDRE HARP
Credential :
Telephone Number : 501-374-6565
Provider Enumeration Date : 06/17/2019
Last Update Date : 06/17/2019

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Directions to “CITY PHARMACY ” Practice Location

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