MEDICARE: LANDMARK PHARMACY, LLC

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
1	333600000X	Pharmacy
2	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1356299853
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANDMARK PHARMACY, LLC

Provider Business Mailing Address
First Line	:	3401 ATWOOD RD STE E
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72206-6078
Country	:	US
Telephone Number	:	501-888-2223
Fax Number	:	501-888-7504

Provider Business Practice Location Address
First Line	:	3401 ATWOOD RD STE E
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72206-6078
Country	:	US
Telephone Number	:	501-888-2223
Fax Number	:	501-888-7504

Authorized Official
Title or Position	:	PHARMACIST
Name	:	LOYD BARRY BULTENA
Credential	:
Telephone Number	:	501-888-2223

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	03/19/2026

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Directions to “LANDMARK PHARMACY, LLC ” Practice Location

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