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General NPI Number Information
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NPI Number | 1538273503
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Entity Type | Organization
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Legal Business Name | CLINIC DRUG OF SEARCY INC
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 11/18/2008
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Provider Practice Location Address
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Address Line | 1120 S MAIN ST STE B
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City | SEARCY
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State | AR
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Zip | 72143
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Country | US
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Telephone | 501-268-5811
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Fax | 501-305-4316
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Provider Business Mailing Address
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Address Line | 1120 S MAIN ST STE B
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City | SEARCY
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State | AR
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Zip | 72143
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Country | US
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Telephone | 501-268-5811
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Fax | 501-305-4316
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Authorized Official
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Title or Position | OWNER PIC
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Name | DEBORA TUCKER
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Credential | PD
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Telephone | 501-268-5811
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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 | AR20379
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License Number State | AR
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