NPI | 1538597752 |
---|---|
Entity Type | Organization |
Authorized Contact | KENNETH ROBERT KUENZEL Owner/President 870-239-4036 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AR AR16734) |
Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: AR AR16734) |
Enumeration Date | 2013-10-25 |
Last Update Date | 2024-03-15 |