Organization
MVP WARREN LLC
Active
Other names
Gannaway Drug
Organization subpart
No
Provider details
NPI number
Authorized official
NIKKI HOOD (CO-OWNER)
(870) 265-2220
Entity
Organization
Contact information
Practice address
101 N MAIN ST, WARREN, AR 71671-2714
(870) 226-3751
(870) 226-3752
Mailing address
PO BOX 552, LAKE VILLAGE, AR 71653-0552
(870) 265-2220
(870) 265-2226
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR06454
AR
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146965
PK
—
Enumeration date
06/24/2014
Last updated
05/25/2023
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