Organization
KAVANAUGH PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS GREGORY COOPER P.D. (PHARMACIST-IN-CHARGE)
(501) 664-3844
Entity
Organization
Contact information
Practice address
5008 KAVANAUGH BLVD, LITTLE ROCK, AR 72207-4747
(501) 664-3844
Mailing address
5008 KAVANAUGH BLVD, LITTLE ROCK, AR 72207-4747
(501) 664-3844
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
AR04183
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0404183
NCPDP NUMBER
—
Enumeration date
02/14/2007
Last updated
03/07/2023
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