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
7507 CANTRELL RD, LITTLE ROCK, AR 72207-2529
(501) 296-9376
(501) 296-9378
Mailing address
7507 CANTRELL RD, LITTLE ROCK, AR 72207-2529
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20549
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0422573
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
01/08/2007
Last updated
12/05/2007
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