MEDICARE: GRIFFINS PHARMACY 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
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	AR20026	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1994235	OTHER		PK

General Provider Information

NPI Number	:	1578562195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRIFFINS PHARMACY INC

Provider Business Mailing Address
First Line	:	239 MAIN ST
Second Line	:
City	:	STAMPS
State	:	AR
Zip	:	71860-2827
Country	:	US
Telephone Number	:	870-533-4351
Fax Number	:	870-533-4351

Provider Business Practice Location Address
First Line	:	239 MAIN ST
Second Line	:
City	:	STAMPS
State	:	AR
Zip	:	71860-2827
Country	:	US
Telephone Number	:	870-533-4351
Fax Number	:	870-533-4351

Authorized Official
Title or Position	:	OWNER
Name	:	WINFRED GRIFFIN
Credential	:
Telephone Number	:	870-533-4351

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	02/27/2017

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Directions to “GRIFFINS PHARMACY INC ” Practice Location

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