# COLLIER DRUG STORES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Collier Drug - Dickson
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730873035
- **Authorized official:** CARL MELVIN COLLIER JR. (OWNER)
- **Authorized official phone:** (479) 442-6262

## Contact information

- **Practice address:** 100 W DICKSON ST, FAYETTEVILLE, AR 72701-5219
- **Practice address phone:** (479) 442-6262
- **Practice address fax:** (479) 521-9111
- **Mailing address:** PO BOX 1085, FAYETTEVILLE, AR 72702-1085
- **Mailing address phone:** (479) 442-6262

## Taxonomy

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

## Other

- **Enumeration date:** 06/08/2023
- **Last updated:** 02/20/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100232407 | — | AR |