Organization
MCCOY-TYGART DRUG STORE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD LOUIS HEDDEN PD (OWNER)
(870) 942-5121
Entity
Organization
Contact information
Practice address
821 N ROCK ST, SHERIDAN, AR 72150-7623
(870) 942-5121
(870) 942-2592
Mailing address
PO BOX 217, SHERIDAN, AR 72150-0217
(870) 942-5121
(870) 942-2592
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100377407
—
AR
Enumeration date
03/13/2020
Last updated
03/13/2020
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