MEDICARE: JEFFERY L. PRICE PHARM.D.

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	183500000X	Pharmacist	PD08764	AR

General Provider Information

NPI Number	:	1790032175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFERY L. PRICE PHARM.D.

Provider Business Mailing Address
First Line	:	2 FOREST PARK DR STE A
Second Line	:
City	:	HOLIDAY ISLAND
State	:	AR
Zip	:	72631-9229
Country	:	US
Telephone Number	:	479-239-2121
Fax Number	:	479-239-2122

Provider Business Practice Location Address
First Line	:	2 FOREST PARK DR STE A
Second Line	:
City	:	HOLIDAY ISLAND
State	:	AR
Zip	:	72631-9229
Country	:	US
Telephone Number	:	479-239-2121
Fax Number	:	479-239-2122

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2012
Last Update Date	:	09/15/2021

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Directions to “ JEFFERY L. PRICE PHARM.D.” Practice Location

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