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General NPI Number Information
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NPI Number | 1780407536
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Entity Type | Organization
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Legal Business Name | SHERIDAN FAMILY PHARMACY LLC
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Dates
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Enumeration Date | 10/31/2024
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 677 HERITAGE DR
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City | SHERIDAN
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State | AR
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Zip | 72150-5000
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Country | US
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Telephone | 870-484-4488
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 217
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City | SHERIDAN
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State | AR
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Zip | 72150-0217
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MEGAN WILSON
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Credential | PHARMD
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Telephone | 501-397-5400
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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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