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General NPI Number Information
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NPI Number | 1841373990
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Entity Type | Organization
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Legal Business Name | FOREMAN PHARMACY INC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 10/30/2011
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Provider Practice Location Address
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Address Line | 106 SCHUMAN ST
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City | FOREMAN
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State | AR
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Zip | 71836
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Country | US
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Telephone | 870-542-6544
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Fax | 870-542-7525
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Provider Business Mailing Address
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Address Line | PO BOX 86
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City | FOREMAN
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State | AR
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Zip | 71836-0086
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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 | PRESIDENT/OWNER
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Name | KENNETH WATTENBARGER
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Credential |
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Telephone | 870-542-6544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | AR20353
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License Number State | AR
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