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Organization

CAEVERETT, INC

Active
Other names
CORNER DRUG STORE
Organization subpart
No

Provider details

NPI number
Authorized official
ABBY EVERETT (OWNER)
(870) 291-0453
Entity
Organization

Contact information

Practice address
830 E MAIN STREET, MELBOURNE, AR 72556
(870) 368-7171
(870) 368-5295
Mailing address
PO BOX 1370, MELBOURNE, AR 72556-1370
(870) 368-7171
(870) 368-5295

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
AR11366
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
158762407
AR
01
1994142
PK
Enumeration date
03/08/2006
Last updated
01/08/2020
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