MEDICARE: CYF 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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1922643006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CYF PHARMACY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 251970
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72225-1970
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1521 MERRILL DR STE D240
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72211-1821
Country	:	US
Telephone Number	:	501-660-6897
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	DAWOOD RASSAM
Credential	:	PHARMACIST
Telephone Number	:	501-660-6897

Provider Enumeration Date	:	11/12/2019
Last Update Date	:	08/05/2022

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