| NPI | 1144301136 |
|---|---|
| Doing Business As | PEDIATRIC NUTRITION PROVIDERS OF ARKANSAS |
| Entity Type | Organization |
| Authorized Contact | LEONARD R GRAY Owner 501-315-2025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AR ar20528) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-08-22 |