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
5914 HIGHWAY 5 N, BRYANT, AR 72202
(501) 847-9001
Mailing address
5914 HIGHWAY 5 N, BRYANT, AR 72022-8555
(501) 847-9001
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
AR20161
AR
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0420517
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
135560407
—
AR
05
—
1508547416
—
AR
Enumeration date
01/08/2007
Last updated
05/02/2008
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