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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
1332B00000XDurable Medical Equipment & Medical Supplies
23336L0003XLong Term Care Pharmacy
3333600000XPharmacyAR-14982AR

Other Identifiers

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

General Provider Information

NPI Number : 1992703243
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 : 804 SOUTH FALLS BLVD
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 : PHARMACIST/OWNER
Name : MAX ALLEN CALDWELL
Credential : RPH
Telephone Number : 870-238-7085
Provider Enumeration Date : 07/11/2005
Last Update Date : 06/09/2021

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Directions to “CALDWELL DISCOUNT DRUG CO., INC. ” Practice Location

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