| NPI | 1578998076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY DON MILHOLEN Pharmacy Executive 479-531-7129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: AR pd05556) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AR pd05556) |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: AR pd05556) | |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2013-09-04 |