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DE QUEEN HEALTH AND WELLNESS PHARMACY LLC NPI 1740420157


NPI Information

NPI: 1740420157
Provider Name: DE QUEEN HEALTH AND WELLNESS PHARMACY LLC

Doing Business As: DE QUEEN HEALTH AND WELLNESS PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 04D2301302

Address:
1357 W COLLIN RAYE DR
DE QUEEN, AR
ZIP 71832
Phone: (870) 642-4458
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DE QUEEN HEALTH AND WELLNESS PHARMACY LLC is a community/retail pharmacy pharmacy in De Queen, 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. DE QUEEN HEALTH AND WELLNESS PHARMACY LLC NPI is 1740420157. The provider is registered as an organization entity type.
The provider Is Doing Business As De Queen Health And Wellness Pharmacy.

The provider's business location address is:

1357 W COLLIN RAYE DR
DE QUEEN, AR
ZIP 71832-946
Phone: (870) 642-4458
Fax: (870) 642-5526

The provider's authorized official is Chester Barber .
The authorized official title is Pharmacist And Owner and has the following contact phone number (870) 642-2400.

The CLIA number assigned to this NPI record is 04D2301302 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/25/2009 and was last updated on 9/27/2011.


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
13336L0003XPharmacyLong Term Care PharmacyNo
2333600000XPharmacyNo
3332B00000XDurable Medical Equipment & Medical SuppliesNo
43336C0003XPharmacyCommunity/Retail PharmacyAR20221ARKANSASYes

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
10421026OTHERNCPDP PROVIDER IDENTIFICATION NUMBER
2200018110AMEDICAIDOKLAHOMA
34269800001MEDICARE NSC
4164404716MEDICAIDARKANSAS
5155535407MEDICAIDARKANSAS

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: 4/28/2024

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