Organization
PREMIER PHARMACY CARE, LLC
Active
Other names
Premier Pharmacy Care, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRAVIS EZELL (COO)
(501) 992-1006
Entity
Organization
Contact information
Practice address
834 E HENRI DE TONTI BLVD, SPRINGDALE, AR 72762-4124
(501) 813-5971
(501) 992-1013
Mailing address
834 E HENRI DE TONTI BLVD, SPRINGDALE, AR 72762
(501) 813-5971
(501) 992-1013
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
AR20822
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2157501
PK
—
Enumeration date
01/13/2016
Last updated
07/23/2025
Update your record
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