National Provider Identifier Database

FOUNTAIN LAKE FAMILY PHARMACY LLC
Long Term Care Pharmacy

A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.


Contact Information

FOUNTAIN LAKE FAMILY PHARMACY LLC
4517 PARK AVE
HOT SPRINGS, AR71901
Phone: 501-547-3400
Fax: 501-521-1033
Website:
Specialty Taxonomy Code
* Long Term Care Pharmacy 3336L0003X

* Indicates primary specialty

NPI Profile & details for FOUNTAIN LAKE FAMILY PHARMACY LLC

NPI Number 1831879451
Legal business name
LBN
FOUNTAIN LAKE FAMILY PHARMACY LLC
Authorized official MICHAEL BUTLER - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 07/19/2023
Last updated 07/19/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • AR Medicaid: 236424407

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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