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General NPI Number Information
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NPI Number | 1730940487
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Entity Type | Organization
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Legal Business Name | COLEMAN PHARMACY OF CRAWFORD COUNTY INC.
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Dates
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Enumeration Date | 01/19/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 110 FAYETTEVILLE AVE
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City | ALMA
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State | AR
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Zip | 72921-3654
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Country | US
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Telephone | 479-262-2156
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Fax | 479-262-2264
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Provider Business Mailing Address
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Address Line | PO BOX 2550
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City | ALMA
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State | AR
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Zip | 72921-2550
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Country | US
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Telephone | 479-262-2156
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Fax | 479-262-2264
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Authorized Official
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Title or Position | CO-OWNER, PHARMACIST IN CHARGE
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Name | PHILLIP JUSTIN BOYD
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Credential | PHARM.D., MBA
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Telephone | 479-262-2156
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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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