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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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