Organization
PARK WEST PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BILL BLOODWORTH (PHARMACY OWNER)
(501) 224-3499
Entity
Organization
Contact information
Practice address
904 AUTUMN RD, SUITE 275, LITTLE ROCK, AR 72211-3702
(501) 224-3499
(501) 224-1140
Mailing address
904 AUTUMN RD, SUITE 275, LITTLE ROCK, AR 72211-3702
(501) 224-3499
(501) 224-1140
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
69175
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100701407
—
AR
Enumeration date
10/05/2005
Last updated
09/12/2012
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