| NPI | 1093570368 |
|---|---|
| Doing Business As | WILSON BEARDEN PHARMACY |
| Entity Type | Organization |
| Authorized Contact | IVY D MOORE Owner 870-234-1062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2024-02-15 |
| Last Update Date | 2024-02-15 |