Organization
ROSE DRUG OF DANVILLE INC
Active
Other names
ROSE DRUG OF DANVILLE
Organization subpart
No
Provider details
NPI number
Authorized official
VANCE PARKER PHARM.D., MBA (PRESIDENT)
(479) 495-7673
Entity
Organization
Contact information
Practice address
708 E 8TH STREET, DANVILLE, AR 72833
(479) 495-7673
(479) 495-7679
Mailing address
PO BOX 471, ARKADELPHIA, AR 71923-0471
(870) 246-5553
(870) 246-6616
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20583
AR
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0422890
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
168234407
—
AR
Enumeration date
06/18/2008
Last updated
04/23/2012
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