| Mrs Mary Carole M Polk, RPH | |
|
333 Madison Street, Clarendon, AR 72029 | |
| (870) 747-3304 | |
| Not Available |
| Full Name | Mrs Mary Carole M Polk |
|---|---|
| Gender | Female |
| Speciality | Pharmacist |
| Location | 333 Madison Street, Clarendon, Arkansas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770685083 | NPI | - | NPPES |
| 20-0270245 | Other | AR | FEDERAL TAX ID |
| 281107-48-001 | Other | AR | SALES AND USE TAX NUMBER |
| 1291951 | Medicaid | LA | |
| 124343407 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 183500000X | Pharmacist | 7925 (Arkansas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Mary Carole M Polk, RPH 55 Normandy Ln, Little Rock, AR 72207-4201 Ph: (501) 690-7519 | Mrs Mary Carole M Polk, RPH 333 Madison Street, Clarendon, AR 72029 Ph: (870) 747-3304 |
Marco Renell Middleton Sr., Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 333 Madison St, Clarendon, AR 72029 Phone: 870-747-3304 | |
Mrs. Leah K Williamson, Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 333 Madison, Clarendon, AR 72029 Phone: 870-747-3304 Fax: 870-747-5324 |