Organization
SUPERMARKET INVESTORS INC
Active
Other names
HARVEST FOODS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA MCCRADY BS PHARMACY (DIRECTOR OF PHARMACY)
(501) 570-0007
Entity
Organization
Contact information
Practice address
10320 STAGECOACH RD, LITTLE ROCK, AR 72210-5746
(501) 455-8080
(501) 455-8327
Mailing address
10320 STAGECOACH RD, LITTLE ROCK, AR 72210-5746
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
AR20022
AR
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0419881
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
01/08/2007
Last updated
12/05/2007
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