Organization
PEDIATRIC NUTRITION PROVIDER OF AR
Active
Other names
Access Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE COURTNEY MOTTO (CO-OWNER)
(501) 315-7337
Entity
Organization
Contact information
Practice address
920 EDISON AVE, SUITE #9, BENTON, AR 72015-4502
(501) 315-7337
Mailing address
920 EDISON AVE, SUITE #9, BENTON, AR 72015-4502
(501) 315-7337
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
AR20528
AR
Other
Enumeration date
05/22/2007
Last updated
08/22/2020
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