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RX MOOSE INC NPI 1396750998


NPI Information

NPI: 1396750998
Provider Name: RX MOOSE INC

Doing Business As: TANGLEWOOD DRUG STORE

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 04D2183143

Address:
6815 CANTRELL RD
LITTLE ROCK, AR
ZIP 72207
Phone: (501) 664-4444
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RX MOOSE INC is a community/retail pharmacy pharmacy in Little Rock, AR. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. RX MOOSE INC NPI is 1396750998. The provider is registered as an organization entity type.
The provider Is Doing Business As Tanglewood Drug Store.

The provider's business location address is:

6815 CANTRELL RD
LITTLE ROCK, AR
ZIP 72207-134
Phone: (501) 664-4444
Fax: (501) 664-7098

The provider's authorized official is Adam Wheeler .
The authorized official title is Owner and has the following contact phone number (501) 664-4444.

The CLIA number assigned to this NPI record is 04D2183143 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/30/2006 and was last updated on 6/26/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail PharmacyAR18118ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11995380OTHERPK
2161521407MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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