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General NPI Number Information
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NPI Number | 1962636829
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Entity Type | Organization
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Legal Business Name | WHITEHALL PHARMACY LLC
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Dates
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Enumeration Date | 05/07/2009
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Last Update Date | 04/21/2023
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Provider Practice Location Address
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Address Line | 7240 SHERIDAN RD STE 102
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City | WHITE HALL
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State | AR
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Zip | 71602-3272
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Country | US
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Telephone | 870-850-8010
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Fax | 870-850-8014
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Provider Business Mailing Address
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Address Line | 7240 SHERIDAN RD STE 102
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City | WHITE HALL
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State | AR
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Zip | 71602-3272
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Country | US
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Telephone | 870-850-8010
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Fax | 870-850-8014
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. FLOYD LELAN STICE
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Credential | PD, MBA
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Telephone | 870-850-8010
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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 | AR20608
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License Number State | AR
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