Organization
AMERICAN HOME PHARMACY LLC
Active
Other names
American Home Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY RIDDLE (PRESIDENT)
(501) 745-4266
Entity
Organization
Contact information
Practice address
454 INGRAM ST, CLINTON, AR 72031-7078
(501) 745-4266
(501) 745-5707
Mailing address
PO BOX 1060, CLINTON, AR 72031-1060
(501) 745-4266
(501) 745-5707
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20639
AR
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190897407
—
AR
01
—
2133298
PK
—
Enumeration date
12/22/2011
Last updated
04/23/2024
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