| NPI | 1174534705 |
|---|---|
| Doing Business As | WILSON BEARDEN PHARMACY |
| Entity Type | Organization |
| Authorized Contact | IVY MOORE Pharmacist And Owner 870-234-1062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AR AR10895) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2016-04-12 |