Healthcare Provider Details

I. General information

NPI: 1487764510
Provider Name (Legal Business Name): LONOKE HEALTH & WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W FRONT ST
LONOKE AR
72086-3117
US

IV. Provider business mailing address

PO BOX 680
LONOKE AR
72086-0680
US

V. Phone/Fax

Practice location:
  • Phone: 501-676-2247
  • Fax: 501-676-3833
Mailing address:
  • Phone: 501-676-2247
  • Fax: 501-676-3833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR20286
License Number StateAR

VIII. Authorized Official

Name: TRISHA L SMITH
Title or Position: OWNER
Credential: PHARMD
Phone: 501-676-2247