Provider Demographics
NPI:1124313267
Name:HOT SPRINGS PHARMACY, LLC
Entity type:Organization
Organization Name:HOT SPRINGS PHARMACY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PIC, MANAGING PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ADUSTON
Authorized Official - Middle Name:STANFORD
Authorized Official - Last Name:SPIVEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:501-767-0573
Mailing Address - Street 1:PO BOX 2085
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71914-2085
Mailing Address - Country:US
Mailing Address - Phone:501-760-2444
Mailing Address - Fax:501-760-2449
Practice Address - Street 1:1210 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-5334
Practice Address - Country:US
Practice Address - Phone:501-760-2444
Practice Address - Fax:501-760-2449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR206583336S0011X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy