Provider Demographics
NPI:1386707107
Name:NEAT RX INC
Entity type:Organization
Organization Name:NEAT RX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:TUBERVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-836-9303
Mailing Address - Street 1:1005 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:AR
Mailing Address - Zip Code:71701-3828
Mailing Address - Country:US
Mailing Address - Phone:870-836-9303
Mailing Address - Fax:
Practice Address - Street 1:1005 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:AR
Practice Address - Zip Code:71701-3828
Practice Address - Country:US
Practice Address - Phone:870-836-9303
Practice Address - Fax:870-837-1537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
ARAR203273336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2144205OtherPK
AR145867407Medicaid