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NPI 1740320431

NPI 1740320431 : MEDI-MART PHARMACY : BRINKLEY, AR

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General NPI Number Information
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    NPI Number           |    1740320431
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    Entity Type          |    Organization 
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    Legal Business Name  |    MEDI-MART PHARMACY 
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Dates
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    Enumeration Date     |    02/08/2007
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    Last Update Date     |    03/07/2023
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Provider Practice Location Address
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    Address Line         |    111 N MAIN ST 
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    City                 |    BRINKLEY
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    State                |    AR
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    Zip                  |    72021-2819
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    Country              |    US
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    Telephone            |    870-734-3161
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    Fax                  |    870-734-1322
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Provider Business Mailing Address
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    Address Line         |    111 N MAIN ST 
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    City                 |    BRINKLEY
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    State                |    AR
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    Zip                  |    72021-2819
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    Country              |    US
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    Telephone            |    870-734-3161
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    Fax                  |    870-734-1322
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Authorized Official
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    Title or Position    |    PHARMACIST & MANAGER
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    Name                 |    MR. SAM R CURRY 
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    Credential           |    P.D.
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    Telephone            |    870-734-3161
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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       |    AR16241
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    License Number State |    AR
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