Organization
ICARERX, INC
Active
Other names
Gammel's Clinic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM ERIC SHOFFNER PD (PHARMACIST-OWNER)
(870) 364-5100
Entity
Organization
Contact information
Practice address
909 UNITY RD, CROSSETT, AR 71635
(870) 364-5100
(870) 364-5120
Mailing address
909 UNITY RD, CROSSETT, AR 71635-9444
(870) 364-5100
(870) 364-5120
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
AR20146
AR
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135016407
—
AR
Enumeration date
02/08/2007
Last updated
07/03/2018
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