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General NPI Number Information
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NPI Number | 1619717204
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Entity Type | Organization
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Legal Business Name | THILO PHARMACY SERVICES LLC
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Dates
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Enumeration Date | 05/30/2024
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Last Update Date | 06/11/2024
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Provider Practice Location Address
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Address Line | 616B HIGHWAY 365
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City | MAYFLOWER
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State | AR
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Zip | 72106-9630
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Country | US
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Telephone | 501-470-9898
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Fax | 501-470-9895
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Provider Business Mailing Address
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Address Line | 616B HIGHWAY 365
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City | MAYFLOWER
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State | AR
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Zip | 72106-9630
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Country | US
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Telephone | 501-470-9898
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Fax | 501-470-9895
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Authorized Official
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Title or Position | PHARMACIST
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Name | MICHAEL J THILO
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Credential | PHARM D
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Telephone | 501-470-9898
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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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