Provider Demographics
NPI:1861587669
Name:MEDISAV HOMECARE PHARMACIES INC
Entity type:Organization
Organization Name:MEDISAV HOMECARE PHARMACIES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMALZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-452-0278
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:AR
Mailing Address - Zip Code:72933-0008
Mailing Address - Country:US
Mailing Address - Phone:479-965-2160
Mailing Address - Fax:479-965-2076
Practice Address - Street 1:1910 S ZERO ST STE A
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72901-8416
Practice Address - Country:US
Practice Address - Phone:479-646-2971
Practice Address - Fax:479-646-8464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
ARAR005413336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1992742OtherPK
AR100521407Medicaid
OK100231780CMedicaid