Healthcare Provider Details

I. General information

NPI: 1992221287
Provider Name (Legal Business Name): SOUTHERN HEALTH AND WELLNESS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2017
Last Update Date: 11/01/2025
Certification Date: 11/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 NEWSOME DR STE A
MARKED TREE AR
72365-2018
US

IV. Provider business mailing address

3005 APACHE DR
JONESBORO AR
72401-7432
US

V. Phone/Fax

Practice location:
  • Phone: 870-358-2135
  • Fax: 870-358-4055
Mailing address:
  • Phone: 870-275-9496
  • Fax: 870-455-0714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR04575
License Number StateAR

VIII. Authorized Official

Name: DR. KYLE ANDREW LOMAX
Title or Position: PRESIDENT
Credential: PHARM. D.
Phone: 870-275-9496