Organization
SUPERMARKET INVESTORS INC
Active
Other names
HARVEST FOODS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA MCCRADY BS PHARMACY (DIRECTOR OF PHARMACY)
(501) 570-0007
Entity
Organization
Contact information
Practice address
2510 CANTRELL RD, LITTLE ROCK, AR 72202-2116
(501) 664-3816
(501) 664-6834
Mailing address
2510 CANTRELL RD, LITTLE ROCK, AR 72202-2116
(501) 664-3816
(501) 664-5530
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
AR20126
AR
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0420327
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
01/08/2007
Last updated
04/04/2008
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