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General NPI Number Information
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NPI Number | 1487572020
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Entity Type | Organization
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Legal Business Name | WILSON PHARMACY LLC
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Dates
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Enumeration Date | 07/09/2026
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Last Update Date | 07/09/2026
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Provider Practice Location Address
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Address Line | 5 N JEFFERSON ST
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City | WILSON
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State | AR
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Zip | 72395-1127
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Country | US
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Telephone | 870-655-8415
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Fax | 870-655-8676
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Provider Business Mailing Address
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Address Line | PO BOX 128
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City | WILSON
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State | AR
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Zip | 72395-0128
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Country | US
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Telephone | 870-655-8415
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Fax | 870-655-8676
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | HEATHER WAGNER
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Credential |
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Telephone | 870-561-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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