Organization
HANCOCK PHARMACY INC
Active
Other names
WALDEN DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY HANCOCK PHARMD (PIC)
(870) 236-6118
Entity
Organization
Contact information
Practice address
3104 W KINGSHIGHWAY, PARAGOULD, AR 72450-2612
(870) 236-6118
(870) 236-5886
Mailing address
3104 W KINGSHIGHWAY, PARAGOULD, AR 72450-2612
(870) 236-6118
(870) 236-5886
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20386
AR
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155534407
—
AR
01
—
1994135
PK
—
05
—
603176306
—
MO
Enumeration date
10/10/2006
Last updated
08/22/2019
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