Provider Demographics
NPI:1902661796
Name:LROCK ADVANCED MANUFACTURING LLC
Entity Type:Organization
Organization Name:LROCK ADVANCED MANUFACTURING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHARMACY OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:501-214-1444
Mailing Address - Street 1:7321 CANTRELL RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-4144
Mailing Address - Country:US
Mailing Address - Phone:501-214-1444
Mailing Address - Fax:501-214-1451
Practice Address - Street 1:7321 CANTRELL RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-4144
Practice Address - Country:US
Practice Address - Phone:501-214-1444
Practice Address - Fax:501-214-1451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy