Organization
VILLAGE APOTHECARY, INC.
Active
Other names
Mt Ida Home Medical & Oxygen
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL D BUTLER PHARM D (PHARMACIST/OWNER)
(501) 922-0777
Entity
Organization
Contact information
Practice address
136 S GEORGE STREET, MT IDA, AR 71957
(870) 867-0106
(870) 867-0134
Mailing address
4440 N HIGHWAY 7, HOT SPRINGS, AR 71909-9301
(501) 922-0777
(501) 922-0787
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119753716
—
AR
Enumeration date
09/09/2014
Last updated
09/09/2014
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