Organization
MAM ENTERPRISES INC
Active
Organization
MAM ENTERPRISES INC
Active
Other names
ARCH STREET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ALAN MCMURRY P.D. (OWNER)
(501) 261-7181
Entity
Organization
Contact information
Practice address
11200 ARCH ST, LITTLE ROCK, AR 72206-4649
(501) 261-7181
(501) 261-7307
Mailing address
PO BOX 241250, LITTLE ROCK, AR 72223-0005
(501) 261-7181
(501) 261-7307
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
AR20275
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142625407
—
AR
01
—
5G678
MEDICARE MASS IMMUNIZATION PTAN
—
Enumeration date
01/17/2007
Last updated
04/12/2011
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