Healthcare Provider Details

I. General information

NPI: 1194825042
Provider Name (Legal Business Name): HOLCOMB'S PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 W MAIN ST
PIGGOTT AR
72454-2039
US

IV. Provider business mailing address

231 W MAIN ST
PIGGOTT AR
72454-2039
US

V. Phone/Fax

Practice location:
  • Phone: 870-598-3183
  • Fax: 870-598-3183
Mailing address:
  • Phone: 870-598-3183
  • Fax: 870-598-3183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR05539
License Number StateAR

VIII. Authorized Official

Name: DR. GAY ELAINE WEGEL
Title or Position: PRESIDENT
Credential: PD
Phone: 870-598-3183