MEDICARE: WOODLANDS PHARMACY MANAGEMENT LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	AR20289	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1989383	OTHER		PK

General Provider Information

NPI Number	:	1841282662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODLANDS PHARMACY MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	7197 SHERIDAN RD STE 109
Second Line	:
City	:	WHITE HALL
State	:	AR
Zip	:	71602-3261
Country	:	US
Telephone Number	:	870-247-3900
Fax Number	:	870-247-2170

Provider Business Practice Location Address
First Line	:	7197 SHERIDAN RD STE 109
Second Line	:
City	:	WHITE HALL
State	:	AR
Zip	:	71602-3261
Country	:	US
Telephone Number	:	870-247-3900
Fax Number	:	870-247-2170

Authorized Official
Title or Position	:	OWNER
Name	:	MEGAN WILSON
Credential	:
Telephone Number	:	501-397-5400

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	11/18/2025

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