Organization
CLARKSVILLE FAMILY PHARMACY INC
Active
Organization
CLARKSVILLE FAMILY PHARMACY INC
Active
Other names
Clarksville Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WARD LEE P.D. (PRESIDENT)
(479) 774-5921
Entity
Organization
Contact information
Practice address
510 S ROGERS ST STE 3, CLARKSVILLE, AR 72830-3792
(479) 647-3138
(479) 647-3144
Mailing address
510 S ROGERS ST STE 3, CLARKSVILLE, AR 72830-3792
(479) 647-3138
(479) 647-3144
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20656
AR
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187120407
—
AR
01
—
2129945
PK
—
Enumeration date
06/15/2011
Last updated
12/16/2016
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