Pediatric Nutrition Prov of Ar
Pediatric Nutrition Prov of Ar is a Pharmacy in Benton, Arkansas. Licensed in Arkansas. Registered with an NPI since 2006.
- Licensed in
- AR
- In the registry since
- 2006
- Specialties on file
- 2
Practice location Address checks out
920 Edison Ave Ste 9Benton, AR 72015-4502
Phone: (501) 315-7337
Fax: (501) 778-7488
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Long Term Care Pharmacy (primary) | Taxonomy 3336L0003X |
|---|---|
| Pharmacy | Taxonomy 333600000X · Licence AR20528 (AR) |
Record details
| NPI number | 1477598795 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Leonard Gray — Co Owner · (901) 315-7337 |
| Other names | Access Pharmacy |
| NPI enumerated | June 19, 2006 |
| Last updated in NPPES | September 11, 2025 |
| Mailing address | 920 Edison Ave, Ste 9, Benton, AR 72015-4502 |
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