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NPI Code Detail

MEDICARE: CALDWELL DISCOUNT DRUG CO INC

MEDICARE: CALDWELL DISCOUNT DRUG CO INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail PharmacyAR14982AR

General Provider Information

NPI Number : 1306280771
Entity Type Code : Organization
Provider Name (Legal Business Name) : CALDWELL DISCOUNT DRUG CO INC
Provider Business Mailing Address
First Line : PO BOX 1084
Second Line :
City : WYNNE
State : AR
Zip : 72396-1084
Country : US
Telephone Number : 870-238-7085
Fax Number : 870-238-8937
Provider Business Practice Location Address
First Line : 804 FALLS BLVD S
Second Line :
City : WYNNE
State : AR
Zip : 72396-3505
Country : US
Telephone Number : 870-238-7085
Fax Number : 870-238-8937
Authorized Official
Title or Position : PRESIDENT / OWNER
Name : MR. MAX A CALDWELL
Credential : P.D.
Telephone Number : 870-238-7085
Provider Enumeration Date : 04/29/2013
Last Update Date : 04/29/2013

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Directions to “CALDWELL DISCOUNT DRUG CO INC ” Practice Location

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