| NPI | 1417021932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD KOEN President 870-367-6291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: AR AR04804) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2020-08-22 |