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Organization

MEDICAL PARK PHARMACY LLC

Active
Other names
MEDICAL PARK PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
VADA MCCALLOUGH RPH (OWNER)
(479) 253-9751
Entity
Organization

Contact information

Practice address
121 E VAN BUREN STE C, EUREKA SPRINGS, AR 72632-3658
(479) 253-9751
(479) 253-7149
Mailing address
121 E. VANBUREN, SUITE C, EUREKA SPRINGS, AR 72632
(479) 253-9751
(479) 253-7149

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
AR20264
AR
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
142172407
AR
01
1992914
PK
05
605854900
MO
Enumeration date
04/10/2006
Last updated
03/27/2017
About Stedi
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