Medicine Man Pharmacy Jfk
LBN: Oak Grove Pharmacy Jfk Inc
Medicine Man Pharmacy Jfk is an health care organization with primary practice located at 5308 John F Kennedy Blvd Ste 3 , North Little Rock AR 72116-6779. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Oak Grove Pharmacy Jfk Inc can be contacted via phone (501) 907-2095, or through Perkins, Terry Wayne via phone (501) 940-7517.
Contact Information
Primary practice address
5308 John F Kennedy Blvd Ste 3
North Little Rock AR 72116-6779
Phone: (501) 907-2095
Fax: (501) 907-2097
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 20695 | Arkansas |
Profile Details
| NPI number | 1053669325 |
|---|---|
| LBN Legal business name | Oak Grove Pharmacy Jfk Inc |
| DBA Doing business as | Medicine Man Pharmacy Jfk |
| Authorized official | Perkins, Terry Wayne PHARMD |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 16th, 2012 |
| Last updated | Jan 17th, 2022 - about 3 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053669325 | NPPES |
| Arkansas | MEDICAID | 196317407 | |
| Arkansas | Other | 2136511 |
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