Healthcare Provider Details

I. General information

NPI: 1811983406
Provider Name (Legal Business Name): CITY DRUG CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1512 LINWOOD DR
PARAGOULD AR
72450-5814
US

IV. Provider business mailing address

1512 LINWOOD DR
PARAGOULD AR
72450-5814
US

V. Phone/Fax

Practice location:
  • Phone: 870-236-8501
  • Fax: 870-239-5324
Mailing address:
  • Phone: 870-236-8501
  • Fax: 870-239-5324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberAR07014
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. JIMMY CHARLES DODD JR.
Title or Position: PRESIDENT OWNER
Credential:
Phone: 870-236-8501