Organization
ARKANSAS HOME MEDICAL INC
Active
Other names
American Home Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY RIDDLE (PRESIDENT)
(501) 730-5445
Entity
Organization
Contact information
Practice address
129 BONE ST, CLINTON, AR 72031-6609
(501) 227-4390
(870) 448-3697
Mailing address
PO BOX 1060, CLINTON, AR 72031-1060
(501) 227-4390
(870) 448-3697
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
AR20639
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0423563
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/22/2006
Last updated
06/25/2013
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