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Suppliers Pharmacy Community/Retail Pharmacy

Provider NPI: 1194186056

Organization Information:
Organization is not Subpart
Authorized Official:  IHAB  HERRAKA  PRESIDENT  479-242-2888

Practice Location:
Tel: 479-242-2888  Fax: 479-242-2889

Business Mailing Address:
Tel: 479-242-2888  Fax: 479-242-2889

NPI Information:
NPI: 1194186056
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Community/Retail Pharmacy

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 3336C0002X





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