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General NPI Number Information
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NPI Number | 1588431563
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Entity Type | Organization
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Legal Business Name | ECONOMY DRUG OF BENTON LLC
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Dates
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Enumeration Date | 12/08/2023
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Last Update Date | 12/08/2023
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Provider Practice Location Address
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Address Line | 500 EDISON
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City | BENTON
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State | AR
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Zip | 72015-5361
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Country | US
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Telephone | 501-776-2716
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Fax | 501-776-0451
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Provider Business Mailing Address
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Address Line | 500 EDISON
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City | BENTON
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State | AR
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Zip | 72015-5361
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Country | US
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Telephone | 501-776-2716
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Fax | 501-776-0451
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Authorized Official
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Title or Position | OWNER
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Name | MR. MICHAEL RALPH MURRAY
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Credential | PD
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Telephone | 501-776-2716
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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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