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General NPI Number Information
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NPI Number | 1487250015
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Entity Type | Organization
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Legal Business Name | GURDON PHARMACY LLC
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Dates
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Enumeration Date | 12/09/2020
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Last Update Date | 04/11/2022
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Provider Practice Location Address
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Address Line | 104 S. 6TH ST
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City | GURDON
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State | AR
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Zip | 71743
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Country | US
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Telephone | 870-353-9900
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Fax | 844-805-7807
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Provider Business Mailing Address
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Address Line | 104 S. 6TH ST
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City | GURDON
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State | AR
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Zip | 71743
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Country | US
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Telephone | 870-353-9900
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Fax | 844-805-7807
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Authorized Official
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Title or Position | PHARMACY OPERATIONS MANAGER
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Name | TODD BEAGLE
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Credential |
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Telephone | 309-642-2620
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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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