Healthcare Provider Details

I. General information

NPI: 1740024835
Provider Name (Legal Business Name): LONOKE HEALTH & WELLNESS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 06/24/2024
Certification Date: 06/23/2024
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 TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RICHARD PENNINGTON
Title or Position: OWNER/PHARMACIST
Credential: PD
Phone: 501-676-2247