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General NPI Number Information
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NPI Number | 1447320528
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Entity Type | Organization
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Legal Business Name | WPM COMMUNITY PHARMACIES LLC
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 11/05/2014
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Provider Practice Location Address
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Address Line | 216 S 13TH ST
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City | ROGERS
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State | AR
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Zip | 72758-4204
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Country | US
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Telephone | 479-621-0400
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Fax | 479-621-7079
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Provider Business Mailing Address
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Address Line | PO BOX 524
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City | ARKADELPHIA
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State | AR
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Zip | 71923-0524
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Country | US
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Telephone | 870-246-5553
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Fax | 870-246-6616
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | W MALONE
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Credential | PD
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Telephone | 870-246-5553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | AR19502
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License Number State | AR
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