ROSE DRUG OF RUSSELLVILLE INC NPI 1952317422

NPI Information

ROSE DRUG OF RUSSELLVILLE, INC is a durable medical equipment medical supplies in Russellville, AR. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. ROSE DRUG OF RUSSELLVILLE, INC NPI is 1952317422. The provider is registered as an organization entity type.

The provider's business location address is:

3103 W MAIN PL
RUSSELLVILLE, AR
ZIP 72801-360
Phone: (479) 968-1050
Fax: (479) 968-1557

The provider's authorized official is Randy Issa Kassissieh .
The authorized official title is Owner and has the following contact phone number (501) 945-3264.

The CLIA number assigned to this NPI record is 04D2184986 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/1/2006 and was last updated on 6/12/2023.

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:

Other Identifiers

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

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