| NPI | 1487104725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW MIZE President/Pharmacist In Charge 479-271-6300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: AR AR20204) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2024-10-07 |