| NPI | 1285168039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH LITTLE Director, Healthcare Contracting An 479-277-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: TX 31275) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2018-04-20 |