Organization
GMT AND P ENTERPRISES
Active
Other names
FLIPPIN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GARY FANCHER (OWNER)
(870) 453-2218
Entity
Organization
Contact information
Practice address
109 N 1ST ST, FLIPPIN, AR 72634-8613
(870) 453-2218
(870) 453-2280
Mailing address
PO BOX 519, FLIPPIN, AR 72634-0519
(870) 453-2218
(870) 453-2280
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
AR09880
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0409880
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
149181716
—
AR
05
—
149186407
—
AR
Enumeration date
02/22/2007
Last updated
04/01/2011
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