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General NPI Number Information
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NPI Number | 1912537713
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Entity Type | Organization
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Legal Business Name | MEDIC PHARMACY INC OF EL DORADO
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Dates
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Enumeration Date | 01/21/2020
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Last Update Date | 01/21/2020
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Provider Practice Location Address
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Address Line | 347 W OAK ST
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City | EL DORADO
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State | AR
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Zip | 71730-4564
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Country | US
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Telephone | 870-862-4931
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Fax | 870-862-6659
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Provider Business Mailing Address
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Address Line | 347 W OAK ST
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City | EL DORADO
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State | AR
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Zip | 71730-4564
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Country | US
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Telephone | 870-862-4931
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Fax | 870-862-6659
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Authorized Official
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Title or Position | TECH
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Name | TONYA RENEE TAYLOR
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Credential | TECH
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Telephone | 870-862-4931
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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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