Healthcare Provider Details

I. General information

NPI: 1356450100
Provider Name (Legal Business Name): RAGAN REXALL DRUG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 S MAIN
STUTTGART AR
72160-4356
US

IV. Provider business mailing address

309 S MAIN
STUTTGART AR
72160-4356
US

V. Phone/Fax

Practice location:
  • Phone: 870-673-2741
  • Fax: 870-673-3016
Mailing address:
  • Phone: 870-673-2741
  • Fax: 870-673-3016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberL0239
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD05278
License Number StateAR

VIII. Authorized Official

Name: MR. R NORRIS RAGAN
Title or Position: PHARMACIST OWNER
Credential: B S PHARMACY
Phone: 870-673-2741