Healthcare Provider Details

I. General information

NPI: 1043318041
Provider Name (Legal Business Name): DELTA DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 S HWY 18 BYPASS
MANILA AR
72442
US

IV. Provider business mailing address

PO BOX 372
MANILA AR
72442-0372
US

V. Phone/Fax

Practice location:
  • Phone: 870-561-3113
  • Fax: 870-561-4291
Mailing address:
  • Phone: 870-561-3113
  • Fax: 870-561-4291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR01163
License Number StateAR

VIII. Authorized Official

Name: LAURA ASHLEY
Title or Position: PHARMACIST
Credential:
Phone: 870-561-3113