Organization
TOWN AND COUNTRY GROCERS OF FREDERICKSTOWN MO INC
Active
Other names
COUNTRY MART PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BOBBIE HUFFORD (CEO)
(573) 783-5703
Entity
Organization
Contact information
Practice address
3106 SOUTHWEST DR, JONESBORO, AR 72404-8404
(870) 933-2016
(870) 933-2031
Mailing address
3106 SOUTHWEST DR, JONESBORO, AR 72404-8404
(870) 933-2016
(870) 933-2031
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20021
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131300407
—
AR
01
—
1988202
PK
—
Enumeration date
11/27/2006
Last updated
01/15/2014
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