Provider Demographics
NPI:1225360027
Name:PHARMACY ACQUISITIONS GROUP LLC
Entity type:Organization
Organization Name:PHARMACY ACQUISITIONS GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VINCE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-972-8310
Mailing Address - Street 1:605 N ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:AR
Mailing Address - Zip Code:72432-1249
Mailing Address - Country:US
Mailing Address - Phone:870-578-5200
Mailing Address - Fax:870-578-5202
Practice Address - Street 1:605 N ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:AR
Practice Address - Zip Code:72432-1249
Practice Address - Country:US
Practice Address - Phone:870-578-5200
Practice Address - Fax:870-578-5202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
ARAR206213336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2123663OtherPK
AR180696407Medicaid