MEDICARE: COLLIER DRUG STORES 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

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

General Provider Information

NPI Number	:	1871286286
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLLIER DRUG STORES INC

Provider Business Mailing Address
First Line	:	PO BOX 1085
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72702-1085
Country	:	US
Telephone Number	:	479-442-6262
Fax Number	:

Provider Business Practice Location Address
First Line	:	197 E MAIN ST
Second Line	:
City	:	FARMINGTON
State	:	AR
Zip	:	72730-3077
Country	:	US
Telephone Number	:	479-267-4303
Fax Number	:	479-267-4311

Authorized Official
Title or Position	:	OWNER
Name	:	CARL MELVIN COLLIER JR.
Credential	:
Telephone Number	:	479-442-6262

Provider Enumeration Date	:	05/31/2023
Last Update Date	:	02/20/2024

Similar Medicare Providers

1427058593 — COLLIER DRUG STORES INC
Practice Location Address:

197 E MAIN ST
FARMINGTON, AR
72730-3077

Practice Phone: 479-267-4303
Practice Fax: 479-267-4311

1518925817 — DEBORAH KAY SWEATT ANP
Practice Location Address:

199 E MAIN ST
FARMINGTON, AR
72730-3077

Practice Phone: 479-267-1001
Practice Fax: 479-267-1026

1952316390 — FARMINGTON FAMILY MEDICAL LLC
Practice Location Address:

199 E MAIN ST
FARMINGTON, AR
72730-3077

Practice Phone: 479-267-1001
Practice Fax: 479-267-1026

1275839011 — WASHINGTON REGIONAL MEDICAL SYSTEM
Practice Location Address:

199 E MAIN ST
FARMINGTON, AR
72730-3077

Practice Phone: 479-267-1001
Practice Fax: 479-267-1026

1063891570 — JANTZEN T SLATER MD
Practice Location Address:

199 E. MAIN ST.
FARMINGTON, AR
72730-3077

Practice Phone: 479-267-1001
Practice Fax: 479-267-1026

1083190318 — JULIA MARIA FUSTER PA-C
Practice Location Address:

199 E MAIN ST
FARMINGTON, AR
72730-3077

Practice Phone: 479-463-1001
Practice Fax: 479-463-1026

Directions to “COLLIER DRUG STORES INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.