| NPI | 1568569309 |
|---|---|
| Doing Business As | DUSTY'S GREEN FOREST PHARMACY |
| Entity Type | Organization |
| Authorized Contact | DUSTY BARRETT Owner/President 479-559-2183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AR AR20398) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2009-11-04 |