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General NPI Number Information
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NPI Number | 1326674870
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Entity Type | Organization
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Legal Business Name | CARAWAY DRUG L.L.C
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Dates
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Enumeration Date | 03/17/2020
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 106 W. STATE STREET
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City | CARAWAY
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State | AR
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Zip | 72419
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Country | US
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Telephone | 870-838-5750
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Fax |
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Provider Business Mailing Address
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Address Line | 4308 CLUBHOUSE DR
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City | JONESBORO
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State | AR
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Zip | 72405-8081
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Country | US
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Telephone | 870-351-2697
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRADLEY TAYLOR HAMILTON
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Credential | PHARM D
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Telephone | 870-351-2697
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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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