Marc Anderson
Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Conway, AR
NPI 1154969707 · NPPES record last updated Feb 18, 2020
Key facts
- NPI
- 1154969707
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
- License
- AR08157 (AR)
- Practice address
- 855 Salem Rd
Conway, AR 72034-4820 - Phone
- (501) 329-3981
- NPI assigned
- Dec 13, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AR08157 | AR | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Limited Partnership I | Past |
Accepting new patients | |
| Kroger Limited Partnership I | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | AR08157 | AR | Yes |
Addresses
Primary practice location
855 Salem Rd
Conway, AR 72034-4820
Mailing address
855 Salem Rd
Conway, AR 72034-4820
Phone (501) 329-3981
Other providers in Conway, AR
- An Angels Touch Bodyworks, LLC
- Anchor Medical, Inc.
- Annette N. Anderson
- Bonnie Anderson
- David E. Anderson
- Jordana R Andrews
- Terrell Lamar Andrews Jr.
- William Hunter Andrews
- Carol A Angel
- Kimberly Angel
All providers in Conway, AR · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.