Organization
RED RIVER PHARMACY OF JONESBORO LLC
Active
Other names
Red River Infusion Pharmacy of Jonesboro, Red River Pharmacy of Jonesboro
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BOUDREAUX (PRESIDENT)
(903) 792-7435
Entity
Organization
Contact information
Practice address
2908 S CARAWAY RD, JONESBORO, AR 72401-7346
(870) 336-2195
(870) 336-2197
Mailing address
1550 MOORES LN, TEXARKANA, TX 75503-4657
(903) 792-7435
(903) 793-0485
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
AR20653
AR
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336N0007X
Nuclear Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2164238
PK
—
01
—
7627810001
PTAN
—
Enumeration date
09/02/2016
Last updated
05/07/2025
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