Organization
TOWN AND COUNTRY GROCERS OF FREDERICKSTOWN MO INC
Active
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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