# DELTA DRUG OF DERMOTT, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Delta Drug of Dermott
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124702592
- **Authorized official:** CALLEY MCNEMAR (MANAGER)
- **Authorized official phone:** (870) 265-2220

## Contact information

- **Practice address:** 111 E PEDDICORD ST, DERMOTT, AR 71638-2314
- **Practice address phone:** (870) 538-5233
- **Practice address fax:** (870) 538-5717
- **Mailing address:** PO BOX 552, LAKE VILLAGE, AR 71653-0552
- **Mailing address phone:** (870) 265-2220
- **Mailing address fax:** (870) 265-2226

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 06/14/2023
- **Last updated:** 06/14/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100262407 | — | AR |