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Contact Information

POLK PHARMACY MANAGEMENT, LLC
333 MADISON STREET
CLARENDON, AR72029
 Phone: 870-747-3304
 Fax: 870-747-5324
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for POLK PHARMACY MANAGEMENT, LLC

NPI # 1972616126
LBN Legal business name POLK PHARMACY MANAGEMENT, LLC
Authorized official BRANDON ACHOR - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/15/2006
Last updated 05/31/2019 - About 7 years ago
Identifiers
AR License # AR18271
AR Medicaid 163890407
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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