Healthcare Provider Details

I. General information

NPI: 1558556555
Provider Name (Legal Business Name): WOODRUFF DRUG CO P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 N ILLINOIS ST
HARRISBURG AR
72432-1249
US

IV. Provider business mailing address

605 N ILLINOIS ST
HARRISBURG AR
72432-1249
US

V. Phone/Fax

Practice location:
  • Phone: 870-578-3277
  • Fax: 870-578-9620
Mailing address:
  • Phone: 870-578-3277
  • Fax: 870-578-9620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberAR20015
License Number StateAR

VIII. Authorized Official

Name: DR. CHERYL C WOODRUFF
Title or Position: OWNER/PHARMACIST IN CHARGE
Credential: P.D.
Phone: 870-578-3277