Organization
FREEDOM PHARMACY LLC
Active
Organization
FREEDOM PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN WALTER ERICKSON PHARM.D. (PHARMACIST / OWNER)
(479) 437-3089
Entity
Organization
Contact information
Practice address
710 4TH ST, MENA, AR 71953-3314
(479) 437-3089
(479) 437-3842
Mailing address
710 4TH ST, MENA, AR 71953-3314
(479) 437-3089
(479) 437-3842
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
AR20630
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200917600A
—
OK
Enumeration date
07/30/2010
Last updated
07/10/2024
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