| NPI | 1902803042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCE ANTHONY BARI Owner, P.D. 870-972-8310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: AR AR10732) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | |
| 333600000X Pharmacy | |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2023-03-14 |