Fountain Lake Family Pharmacy Llc

LBN: Fountain Lake Family Pharmacy Llc
Fountain Lake Family Pharmacy Llc is an health care organization with primary practice located at 4517 Park Ave , Hot Springs AR 71901. The organization recently has only one registered license in Suppliers / Long Term Care Pharmacy, which is considered as the primary health care specialty. Fountain Lake Family Pharmacy Llc can be contacted via phone (501) 547-3400, or through Butler, Michael via phone (501) 547-3400.

Contact Information

Primary practice address
4517 Park Ave Hot Springs AR 71901
Phone: (501) 547-3400
Fax: (501) 521-1033
Website:
Map and Directions
Authorized official contact:
Name: Butler, Michael
Phone: (501) 547-3400

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1831879451
LBN Legal business name Fountain Lake Family Pharmacy Llc
DBA Doing business as
Authorized official Butler, Michael
Entity Organization
Organization subpart 1 No
Enumeration date Jul 19th, 2023
Last updated Jul 19th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831879451 NPPES
Arkansas MEDICAID 236424407

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