Organization
WILSON PHARMACY LLC
Active
Other names
Wilson Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER WAGNER RPH (PHARMACIST/OWNER)
(870) 655-8415
Entity
Organization
Contact information
Practice address
5 N JEFFERSON ST, WILSON, AR 72395-1127
(870) 655-8415
(870) 655-8676
Mailing address
PO BOX 128, WILSON, AR 72395-0128
(870) 655-8415
(870) 655-8676
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
AR20387
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187710407
—
AR
01
—
2166426
PK
—
Enumeration date
02/28/2007
Last updated
12/07/2016
Update your record
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