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General NPI Number Information
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NPI Number | 1871128306
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Entity Type | Organization
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Legal Business Name | SOUTHEAST ARKANSAS PHARMACIES LLC
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Dates
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Enumeration Date | 03/05/2020
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Last Update Date | 03/05/2020
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Provider Practice Location Address
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Address Line | 539 HIGHWAY 425 S
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City | MONTICELLO
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State | AR
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Zip | 71655-4674
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Country | US
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Telephone | 870-367-4227
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Fax | 870-367-4211
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Provider Business Mailing Address
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Address Line | 539 HIGHWAY 425 S
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City | MONTICELLO
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State | AR
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Zip | 71655-4674
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Country | US
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Telephone | 870-367-4227
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Fax | 870-367-4211
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Authorized Official
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Title or Position | OWNER/PHARMACIST IN CHARGE
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Name | DR. BRIAN WAYNE SMITH
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Credential |
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Telephone | 870-367-4227
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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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