Organization
KAVANAUGHRX LLC
Active
Other names
Kavanaugh Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE PACE PHARMD (OWNER PIC)
(501) 664-3855
Entity
Organization
Contact information
Practice address
5200 KAVANAUGH BLVD, LITTLE ROCK, AR 72207-4609
(501) 664-3844
(501) 664-3744
Mailing address
5200 KAVANAUGH BLVD, LITTLE ROCK, AR 72207-4609
(501) 664-3844
(501) 664-3744
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR04183
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100024407
—
AR
01
—
2141594
PK
—
Enumeration date
07/17/2013
Last updated
05/12/2023
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