MEDICARE: EAST END EXPRESS PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1740012038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST END EXPRESS PHARMACY INC

Provider Business Mailing Address
First Line	:	21019 HIGHWAY 167 STE 100
Second Line	:
City	:	HENSLEY
State	:	AR
Zip	:	72065-8154
Country	:	US
Telephone Number	:	501-486-4100
Fax Number	:

Provider Business Practice Location Address
First Line	:	21019 HIGHWAY 167 STE 100
Second Line	:
City	:	HENSLEY
State	:	AR
Zip	:	72065-8154
Country	:	US
Telephone Number	:	501-486-4100
Fax Number	:	501-486-4101

Authorized Official
Title or Position	:	SECRETARY/TREASURER
Name	:	DR. ERIN B GREENE
Credential	:	PHARMD
Telephone Number	:	501-486-4100

Provider Enumeration Date	:	08/15/2024
Last Update Date	:	08/15/2024

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Directions to “EAST END EXPRESS PHARMACY INC ” Practice Location

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