MEDICARE: WARMACK PHARMACIES 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	3336L0003X	Long Term Care Pharmacy
2	3336C0003X	Community/Retail Pharmacy

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669423810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WARMACK PHARMACIES INC

Provider Business Mailing Address
First Line	:	908 W 4TH ST
Second Line	:
City	:	FORDYCE
State	:	AR
Zip	:	71742-2216
Country	:	US
Telephone Number	:	870-352-2161
Fax Number	:	870-352-3236

Provider Business Practice Location Address
First Line	:	802 W 4TH ST
Second Line	:
City	:	FORDYCE
State	:	AR
Zip	:	71742
Country	:	US
Telephone Number	:	870-352-2161
Fax Number	:	870-352-3236

Authorized Official
Title or Position	:	BOOKKEEPER / PHARMACY TECH
Name	:	MS. DEBORAH HERRING
Credential	:
Telephone Number	:	870-352-2161

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	01/14/2019

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Directions to “WARMACK PHARMACIES INC ” Practice Location

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