Organization
WILSON BEARDEN PHARMACY INC
Active
Other names
WILSON BEARDEN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
IVY MOORE PD (PHARMACIST AND OWNER)
(870) 234-1062
Entity
Organization
Contact information
Practice address
134 N WASHINGTON, MAGNOLIA, AR 71753-2856
(870) 234-1062
(870) 234-8366
Mailing address
PO BOX 597, MAGNOLIA, AR 71754-0597
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR10895
AR
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1994116
PK
—
05
—
210631407
—
AR
Enumeration date
08/10/2006
Last updated
04/12/2016
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up