RED RIVER PHARMACY OF JONESBORO LLC NPI 1609323922

NPI Information

NPI: 1609323922
Provider Name: RED RIVER PHARMACY OF JONESBORO LLC

Doing Business As: RED RIVER INFUSION PHARMACY OF JONESBORO

Classification: Pharmacy - 3336N0007X
Entity Type: Organization

Specialization: Nuclear Pharmacy

Address:
910 PROFESSIONAL ACRES DR
JONESBORO, AR
ZIP 72401
Phone: (870) 336-2195
Get Directions

RED RIVER PHARMACY OF JONESBORO LLC is a nuclear pharmacy pharmacy in Jonesboro, AR. The provider is a pharmacy dedicated to the compounding and dispensing of radioactive materials for use in nuclear imaging and nuclear medical procedures. RED RIVER PHARMACY OF JONESBORO LLC NPI is 1609323922. The provider is registered as an organization entity type.
The provider Is Doing Business As Red River Infusion Pharmacy Of Jonesboro.

The provider's business location address is:

910 PROFESSIONAL ACRES DR
JONESBORO, AR
ZIP 72401-321
Phone: (870) 336-2195
Fax: (870) 336-2197

The provider's authorized official is David Boudreaux .
The authorized official title is President and has the following contact phone number (903) 792-7435.

The enumeration date for this NPI number is 9/2/2016 and was last updated on 8/26/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251F00000X	Home Infusion				No
2	332B00000X	Durable Medical Equipment & Medical Supplies				No
3	332BP3500X	Durable Medical Equipment & Medical Supplies	Parenteral & Enteral Nutrition			No
4	333600000X	Pharmacy		AR20653	ARKANSAS	No
5	3336H0001X	Pharmacy	Home Infusion Therapy Pharmacy			No
6	3336N0007X	Pharmacy	Nuclear Pharmacy			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7627810001	OTHER		PTAN
2	2164238	OTHER		PK

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

NPI Synchronization or Removal

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