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Organization

WESTSIDE FAMILY PHARMACY INC

Active
Other names
WESTSIDE HEALTH MART PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
JONATHAN RAGAN PHRM (OWNER, PIC)
(479) 756-3232
Entity
Organization

Contact information

Practice address
3819 W SUNSET AVE, SPRINGDALE, AR 72762-4959
(479) 756-3232
(479) 756-1217
Mailing address
3819 W SUNSET AVE, SPRINGDALE, AR 72762-4959
(479) 756-3232
(479) 756-1217

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
AR20556
AR
3336C0004X
Compounding Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
163497407
AR
05
187155716
AR
01
1989788
PK
Enumeration date
03/23/2007
Last updated
12/22/2014
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