Pruetts Food-Pharmacy#3
LBN: Pruetts Food Inc
Pruetts Food-Pharmacy#3 is an health care organization with primary practice located at 500 E Collin Raye Dr , De Queen AR 71832-8048. 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.
Pruetts Food Inc can be contacted via phone (870) 642-5680, or through Pruett, Shannon Jewelanna via phone (580) 584-6089.
Contact Information
Primary practice address
500 E Collin Raye Dr
De Queen AR 71832-8048
Phone: (870) 642-5680
Fax: (870) 642-5683
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | AR14401 | Arkansas |
Profile Details
| NPI number | 1659648285 |
|---|---|
| LBN Legal business name | Pruetts Food Inc |
| DBA Doing business as | Pruetts Food-Pharmacy#3 |
| Authorized official | Pruett, Shannon Jewelanna |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 28th, 2011 |
| Last updated | Jan 31st, 2021 - 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 | 1659648285 | NPPES |
| Oklahoma | MEDICAID | 20001990D | |
| Oklahoma | Other | 2132858 | |
| Oklahoma | MEDICAID | 190021407A |
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