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General NPI Number Information
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NPI Number | 1265568745
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Entity Type | Organization
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Legal Business Name | JONES DRUG STORE
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 216 GREENWOOD AVE SOUTH
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City | LEPANTO
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State | AR
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Zip | 72354
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Country | US
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Telephone | 870-475-2617
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Fax | 870-475-2617
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Provider Business Mailing Address
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Address Line | PO BOX 723
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City | LEPANTO
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State | AR
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Zip | 72354-0723
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Country | US
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Telephone | 870-475-2617
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Fax | 870-475-2617
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Authorized Official
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Title or Position | PHARMACIST
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Name | SAM HOLCOMB
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Credential | PHD
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Telephone | 870-475-2617
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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 | AR03953
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License Number State | AR
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