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General NPI Number Information
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NPI Number | 1184736175
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Entity Type | Organization
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Legal Business Name | SMEE DRUG STORE INC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 01/27/2010
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Provider Practice Location Address
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Address Line | 32 W MAIN ST
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City | BOONEVILLE
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State | AR
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Zip | 72927-3635
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Country | US
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Telephone | 479-675-2306
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Fax | 479-675-2745
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Provider Business Mailing Address
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Address Line | PO BOX 479
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City | BOONEVILLE
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State | AR
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Zip | 72927-0479
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Country | US
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Telephone | 479-675-2306
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Fax | 479-675-2745
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE PRESIDENT
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Name | MARY ELIZABETHQ FERGUSON
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Credential | PD
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Telephone | 479-675-2306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | AR13637
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License Number State | AR
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