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General NPI Number Information
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NPI Number | 1023445293
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Entity Type | Organization
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Legal Business Name | MCKINNEY DRUG STORES INC
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Dates
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Enumeration Date | 10/03/2013
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Last Update Date | 08/27/2020
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Provider Practice Location Address
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Address Line | 400 W EMMA AVE
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City | SPRINGDALE
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State | AR
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Zip | 72764-4471
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Country | US
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Telephone | 479-750-2220
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Fax | 479-750-2031
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Provider Business Mailing Address
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Address Line | 400 W EMMA AVE
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City | SPRINGDALE
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State | AR
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Zip | 72764-4471
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Country | US
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Telephone | 479-750-2220
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Fax | 479-750-2031
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Authorized Official
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Title or Position | OWNER/PHARMACIST IN CHARGE
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Name | DR. VICTORIA HENNESSEY
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Credential | PHARM.D.
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Telephone | 479-750-2220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | AR20731
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License Number State | AR
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