| NPI | 1093009292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA NAGY Credentialing COO Rdinator 479-313-6888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: AR AR20654) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2023-05-24 |