1043310360 NPI number — HARPS FOOD STORES, INC

Table of content: (NPI 1043310360)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043310360 NPI number — HARPS FOOD STORES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARPS FOOD STORES, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PRICE CUTTER PHARMACY 352
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043310360
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 48
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGDALE
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72765-0048
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 CLOVERLEAF PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VAN BUREN
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72956-5042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-471-0800
Provider Business Practice Location Address Fax Number:
479-471-8367
Provider Enumeration Date:
09/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ACORD
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF PHARMACY
Authorized Official Telephone Number:
479-757-0225

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  AR20310 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0420834 . This is a "OTHER ID NUMBER-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100247170A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 145218407 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com