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General NPI Number Information
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NPI Number | 1215557905
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Entity Type | Organization
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Legal Business Name | MEDMAN23, INC
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Dates
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Enumeration Date | 04/22/2020
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Last Update Date | 01/17/2022
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Provider Practice Location Address
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Address Line | 3201 SPRINGHILL DR STE 110
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72117-2910
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Country | US
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Telephone | 501-476-3514
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Fax |
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Provider Business Mailing Address
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Address Line | 3201 SPRINGHILL DR STE 110
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72117-2910
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Country | US
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Telephone | 501-476-3514
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Fax | 501-235-3964
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | DR. TERRY WAYNE PERKINS
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Credential | PHARMD
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Telephone | 501-940-7517
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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 |
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License Number State |
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