Healthcare Provider Details

I. General information

NPI: 1902946668
Provider Name (Legal Business Name): PHILS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 HWY 70 WAST
GLENWOOD AR
71943
US

IV. Provider business mailing address

PO BOX 8
GLENWOOD AR
71943-0008
US

V. Phone/Fax

Practice location:
  • Phone: 870-356-7445
  • Fax: 870-356-3299
Mailing address:
  • Phone: 870-356-7445
  • Fax: 870-356-3299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number009089
License Number StateAR

VIII. Authorized Official

Name: MR. JAMES PHILLIP BUCK SR.
Title or Position: OWNER
Credential: RPH
Phone: 870-356-7445