PEDIATRIC NUTRITION PROVIDER OF AR NPI 1588873053

NPI Information

PEDIATRIC NUTRITION PROVIDER OF AR is a parenteral and enteral nutrition durable medical equipment medical supplies in Benton, AR. PEDIATRIC NUTRITION PROVIDER OF AR NPI is 1588873053. The provider is registered as an organization entity type.
The provider Is Doing Business As Access Pharmacy.

The provider's business location address is:

920 EDISON AVE
SUITE #9
BENTON, AR
ZIP 72015-502
Phone: (501) 315-7337

The provider's authorized official is Nicole Courtney Motto .
The authorized official title is Co-owner and has the following contact phone number (501) 315-7337.

The enumeration date for this NPI number is 5/22/2007 and was last updated on 8/22/2020.

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:

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