Organization
MED CENTER PHARMACY
Active
Other names
MED CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL BURGE RPH (MANAGER)
(870) 892-4495
Entity
Organization
Contact information
Practice address
2901 MEDICAL CENTER DR, POCAHONTAS, AR 72455-9438
(870) 892-4495
(870) 892-1833
Mailing address
2901 MEDICAL CENTER DR, POCAHONTAS, AR 72455-9438
(870) 892-4495
(870) 892-1833
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR17243
AR
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121103407
—
AR
01
—
1995150
PK
—
Enumeration date
08/31/2006
Last updated
04/04/2017
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