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General NPI Number Information
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NPI Number | 1215037536
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Entity Type | Organization
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Legal Business Name | CONCORD FOOD STORES LLC
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 6 E SHAWNEE RD
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City | MUSKOGEE
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State | OK
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Zip | 74403-1001
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Country | US
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Telephone | 918-681-4403
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Fax | 918-681-4436
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Provider Business Mailing Address
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Address Line | PO BOX 48
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City | SPRINGDALE
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State | AR
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Zip | 72765-0048
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | RICHARD ROBINSON
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Credential |
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Telephone | 479-757-0225
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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 | 044659
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License Number State | OK
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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 |
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License Number State |
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