Healthcare Provider Details

I. General information

NPI: 1982254082
Provider Name (Legal Business Name): WHITEHALL PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2019
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S LINCOLN AVE
STAR CITY AR
71667-5208
US

IV. Provider business mailing address

205 E 2ND AVE
PINE BLUFF AR
71601-4443
US

V. Phone/Fax

Practice location:
  • Phone: 870-628-4004
  • Fax: 870-628-4004
Mailing address:
  • Phone: 870-628-4004
  • Fax: 870-628-4004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: FLOYD LELAN STICE
Title or Position: OWNER
Credential:
Phone: 501-442-4657