Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pediatric Nutrition Prov of Ar

Organization Pharmacy · NPI 1477598795

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 9
Benton, AR 72015-4502
Phone: (501) 315-7337
Fax: (501) 778-7488
Show map & directions

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 number1477598795
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Leonard Gray — Co Owner · (901) 315-7337
Other names Access Pharmacy
NPI enumeratedJune 19, 2006
Last updated in NPPESSeptember 11, 2025
Mailing address920 Edison Ave, Ste 9, Benton, AR 72015-4502

Other providers in Benton