Healthcare Provider Details

I. General information

NPI: 1366453946
Provider Name (Legal Business Name): SOUTHERN HEALTH AND WELLNESS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 11/01/2025
Certification Date: 11/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 W DREW AVE
MONETTE AR
72447-9010
US

IV. Provider business mailing address

3005 APACHE DR
JONESBORO AR
72401-7432
US

V. Phone/Fax

Practice location:
  • Phone: 870-486-2111
  • Fax: 870-486-2565
Mailing address:
  • Phone: 870-275-9496
  • Fax: 870-931-0992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR17344
License Number StateAR
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

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