Healthcare Provider Details

I. General information

NPI: 1508780297
Provider Name (Legal Business Name): WILKARE PHARMACY OF DONIPHAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 FRONT STREET
NAYLOR MO
63953
US

IV. Provider business mailing address

3104 CASCADE ST
JONESBORO AR
72404-9014
US

V. Phone/Fax

Practice location:
  • Phone: 573-850-4079
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: PHILLIP KEITH WILKINS JR.
Title or Position: MANAGING MEMBER
Credential:
Phone: 573-276-3784