Organization
FAITH & HOPE INC
Active
Other names
MEDI SHOP PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KAY K GARNER LPN (TREASURER)
(479) 394-3254
Entity
Organization
Contact information
Practice address
204 HIGHWAY 71 S, MENA, AR 71953-4638
(479) 394-3254
(479) 394-0235
Mailing address
204 HIGHWAY 71 S, MENA, AR 71953-4638
(479) 394-3254
(479) 394-0235
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20383
AR
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0421987
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
156262407
—
AR
05
—
20074980
—
OK
Enumeration date
10/20/2006
Last updated
09/15/2011
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