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General NPI Number Information
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NPI Number | 1245228824
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Entity Type | Organization
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Legal Business Name | MEDIC PHARMACY OF BRYANT, INC.
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Dates
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Enumeration Date | 10/08/2005
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Last Update Date | 10/12/2021
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Provider Practice Location Address
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Address Line | 306 N REYNOLDS RD
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City | BRYANT
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State | AR
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Zip | 72022-3440
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Country | US
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Telephone | 501-847-3596
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Fax | 501-847-9020
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Provider Business Mailing Address
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Address Line | 306 N REYNOLDS RD
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City | BRYANT
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State | AR
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Zip | 72022-3440
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Country | US
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Telephone | 501-847-3596
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Fax | 501-847-9020
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BRYANT SIZEMORE
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Credential | PHARM.D.
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Telephone | 501-847-3596
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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 | AR01240
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License Number State | AR
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