Organization
MARVELL CLINIC PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN WILLIAM GRAY PHARMACIST (OWNER PHARM)
(870) 829-1044
Entity
Organization
Contact information
Practice address
406 S MILL ST, MARVEL, AR 72366-0217
(870) 829-1044
(870) 829-1067
Mailing address
PO BOX 217, 406 S. MILL ST, MARVELL, AR 72366-0217
(870) 829-1044
(870) 829-1067
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
AR20373
AR
333600000X
Pharmacy
Primary
AR20373
AR
Other
Enumeration date
07/16/2006
Last updated
02/11/2008
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