Healthcare Provider Details

I. General information

NPI: 1649332511
Provider Name (Legal Business Name): STERLING DRUG COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 12/13/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E. BUCHANAN STREET
PRAIRIE GROVE AR
72753
US

IV. Provider business mailing address

PO BOX 1008
PRAIRIE GROVE AR
72753-1008
US

V. Phone/Fax

Practice location:
  • Phone: 479-846-2135
  • Fax: 479-846-3940
Mailing address:
  • Phone: 479-846-2135
  • Fax: 479-846-3940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number67189
License Number StateAR

VIII. Authorized Official

Name: JOHN LYKINS
Title or Position: OWNER
Credential:
Phone: 479-846-2135