Organization
AMERICAN HOME PHARMACY LLC
Active
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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