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Organization
HERITAGE SENIOR CARE LLC
Active
Organization
HERITAGE SENIOR CARE LLC
Active
Other names
Heritage Senior Care
Organization subpart
No
Provider details
NPI number
Authorized official
MARK MCMURRY (OWNER)
(501) 650-4709
Entity
Organization
Contact information
Practice address
607 W MAIN ST STE B, JACKSONVILLE, AR 72076-4431
(501) 475-0396
(501) 475-0398
Mailing address
607 W MAIN ST STE B, JACKSONVILLE, AR 72076-4431
(501) 475-0396
(501) 475-0398
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
—
NULL
3336H0001X
Home Infusion Therapy Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153063
PK
—
Enumeration date
07/09/2015
Last updated
07/16/2015
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