Provider Demographics
NPI:1366784779
Name:PARKS, RICHARD EARL (RPH)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:EARL
Last Name:PARKS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 W CENTER ST
Mailing Address - Street 2:PHARMACY
Mailing Address - City:GREENWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72936-3726
Mailing Address - Country:US
Mailing Address - Phone:479-996-5522
Mailing Address - Fax:479-996-5528
Practice Address - Street 1:705 W CENTER ST
Practice Address - Street 2:PHARMACY
Practice Address - City:GREENWOOD
Practice Address - State:AR
Practice Address - Zip Code:72936-3726
Practice Address - Country:US
Practice Address - Phone:479-996-5522
Practice Address - Fax:479-996-5528
Is Sole Proprietor?:No
Enumeration Date:2013-03-24
Last Update Date:2013-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD07337183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist