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SARDIS ROAD DRUG INC. NPI 1568453793


NPI Information

NPI: 1568453793
Provider Name: SARDIS ROAD DRUG INC.

Doing Business As: SHANNON HILLS PHARMACY

Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
13907 HIGH RD
MABELVALE, AR
ZIP 72103
Phone: (501) 455-1086
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SARDIS ROAD DRUG INC. is a pharmacy in Mabelvale, AR. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. SARDIS ROAD DRUG INC. NPI is 1568453793. The provider is registered as an organization entity type.
The provider Is Doing Business As Shannon Hills Pharmacy.

The provider's business location address is:

13907 HIGH RD
MABELVALE, AR
ZIP 72103-212
Phone: (501) 455-1086
Fax: (501) 455-4780

The provider's authorized official is John Carl Griffin .
The authorized official title is Owner/pharmacist and has the following contact phone number (501) 455-1086.

The enumeration date for this NPI number is 11/4/2005 and was last updated on 3/7/2023.


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
1333600000XPharmacyAR01303ARKANSASYes

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
1100458407MEDICAIDARKANSAS

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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