Organization
PEDIATRIC NUTRITION PROVIDER OF AR
Active
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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