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JASEN CREEK PD

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1477958155

Individual Registrant:
 JASEN  CREEK PD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1430 W 1ST ST N  PRESCOTT, AR 71857-3339 US
Tel: 870-887-6664  Fax: 870-887-2968

Contact information for business:
PO BOX 524  ARKADELPHIA, AR 71923-0524 US
Tel: 870-246-5553  Fax: 870-245-1790

Registration Information:
NPI: 1477958155
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
ARPD08834

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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