Organization
NORTHEAST ARK PHARMACY SERVICES
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
DENA FERMAN (THIRD PARTY PLAN COORDINATOR)
(314) 993-6000
Entity
Organization
Contact information
Practice address
1803 W KINGSHIGHWAY, PARAGOULD, AR 72450-3559
(870) 239-2281
(870) 239-0351
Mailing address
1803 W KINGSHIGHWAY, PARAGOULD, AR 72450-3559
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
0416342
AR
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0416342
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/15/2006
Last updated
09/11/2025
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