Healthcare Provider Details

I. General information

NPI: 1245240746
Provider Name (Legal Business Name): LAGRONE DRUG, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N MAIN ST
HAMBURG AR
71646-3264
US

IV. Provider business mailing address

201 N MAIN ST
HAMBURG AR
71646-3264
US

V. Phone/Fax

Practice location:
  • Phone: 870-853-8666
  • Fax: 870-853-8860
Mailing address:
  • Phone: 870-853-8666
  • Fax: 870-853-8860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number03131
License Number StateAR

VIII. Authorized Official

Name: MRS. KELLI JANE PERRY
Title or Position: OWNER/PHARMACIST-IN-CHARGE
Credential: PD
Phone: 870-853-8666