Pediatric Nutrition Prov Of Ar in Benton - Long Term Care Pharmacy
Pediatric Nutrition Prov Of Ar - NPI 1477598795
Pediatric Nutrition Prov Of Ar is a Long Term Care Pharmacy in Benton, Arkansas. Pediatric Nutrition Prov Of Ar practices all healthcare services and medical treatments related to Long Term Care Pharmacy. The NPI Number for Pediatric Nutrition Prov Of Ar is 1477598795. The last update date is 2020-08-22.
Pediatric Nutrition Prov Of Ar's current location address is 920 Edison Ave, Benton, Arkansas. You can contact this provider via phone number 5013157337 and fax number 5017787488. The mailing address for Pediatric Nutrition Prov Of Ar is 920 Edison Ave, Benton, Arkansas. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Pediatric Nutrition Prov Of Ar |
|---|---|
| Address | 920 Edison Ave, Benton, Arkansas |
| Phone Number | 5013157337 |
| Fax Number | 5017787488 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CO OWNER |
|---|---|
| Authorized Official Name | Gray Leonard |
| Credentials | PHARMD |
| Telephone Number | 9013157337 |
NPI Number Detail
| NPI Number | 1477598795 |
|---|---|
| Provider Enumeration Date | 2006-06-19 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 920 Edison Ave |
|---|---|
| City | Benton |
| State | Arkansas (AR) |
| Post Code | 720154502 |
| Phone Number | 5013157337 |
| Fax Number | 5017787488 |
Provider's Primary Taxonomy Detail
| Speciality | Long Term Care Pharmacy |
|---|---|
| Taxonomy | 3336L0003X |
|
Definition: A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregat |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 422357 | OTHER ID NUMBER-COMMERCIAL NUM |
Post Comment/ Review Below
What is the unique provider identifier assigned to Pediatric Nutrition Prov Of Ar?
The Pediatric Nutrition Prov Of Ar has been issued the NPI (National Provider Identifier) 1477598795 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical address where Pediatric Nutrition Prov Of Ar is geographically located?
The Pediatric Nutrition Prov Of Ar is physically situated at the following location: 920 Edison Ave, Benton, AR, 720154502.
What is Pediatric Nutrition Prov Of Ar's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Pediatric Nutrition Prov Of Ar's specialized field of practice is Long Term Care Pharmacy, and the corresponding taxonomy code that categorizes this area of specialization is 3336L0003X.
On what date did Pediatric Nutrition Prov Of Ar receive its 1477598795 assignment from the Centers for Medicare & Medicaid Services?
The Pediatric Nutrition Prov Of Ar was assigned its 1477598795 on 2006-06-19, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Pediatric Nutrition Prov Of Ar most recently updated or revised?
The information pertaining to Pediatric Nutrition Prov Of Ar, including its address, specialty, and other relevant details, was last updated or revised on 2020-08-22.
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