NPI | 1386761757 |
---|---|
Doing Business As | WESTSIDE HEALTH MART PHARMACY |
Entity Type | Organization |
Authorized Contact | JONATHAN RAGAN Owner, PIC 479-756-3232 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AR AR20556) |
Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
332B00000X Durable Medical Equipment & Medical Supplies | |
Enumeration Date | 2007-03-23 |
Last Update Date | 2014-12-22 |