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
1	333600000X	Pharmacy	0412609	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841291150
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	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ANDREW HARP
Credential	:	PHARM.D
Telephone Number	:	501-374-6565

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	05/26/2015

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Directions to “CITY PHARMACY ” Practice Location

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