NPI: 1013422179 · CONWAY, AR 72034 · Pharmacy · NPI assigned 12/11/2017
| Authorized Official | HOLDERFIELD, ZACH (PARTNER/AO) |
| NPI Enumeration Date | 12/11/2017 |
Other providers sharing the same authorized official: HOLDERFIELD, ZACH
| Provider | City | State | Total Paid |
|---|---|---|---|
| PPG STORE 3, LLC | LITTLE ROCK | AR | $223K |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 17 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 0013A | 17 | 17 | $0.00 |