| NPI | 1265773386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH LITTLE Director Of Healthcare Contracting 479-277-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: IL 054018289) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2023-08-30 |