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Organization
PEDIATRIC NUTRITION PROV OF AR
Active
Organization
PEDIATRIC NUTRITION PROV OF AR
Active
Other names
ACCESS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LEONARD GRAY PHARMD (CO OWNER)
(901) 315-7337
Entity
Organization
Contact information
Practice address
920 EDISON AVE, STE 9, BENTON, AR 72015-4502
(501) 315-7337
(501) 778-7488
Mailing address
920 EDISON AVE, STE 9, BENTON, AR 72015-4502
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
AR20528
AR
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0422357
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/19/2006
Last updated
09/11/2025
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