Organization
OAK GROVE PHARMACY JFK INC
Active
Organization
OAK GROVE PHARMACY JFK INC
Active
Other names
Medicine Man Pharmacy JFK
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY WAYNE PERKINS PHARMD (PHARMACIST/OWNER)
(501) 940-7517
Entity
Organization
Contact information
Practice address
5308 JOHN F KENNEDY BLVD STE 3, NORTH LITTLE ROCK, AR 72116-6779
(501) 907-2095
(501) 907-2097
Mailing address
5308 JOHN F KENNEDY BLVD STE 3, NORTH LITTLE ROCK, AR 72116-6779
(501) 907-2095
(501) 907-2097
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
20695
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196317407
—
AR
01
—
2136511
PK
—
Enumeration date
08/16/2012
Last updated
01/17/2022
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