Organization
TOMMYS REXALL DRUG COMPANY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOMMY BLACK (OWNER)
(870) 946-4221
Entity
Organization
Contact information
Practice address
220 COURT SQ, DE WITT, AR 72042-2057
(870) 946-4221
(870) 946-1181
Mailing address
220 COURT SQ, DE WITT, AR 72042-2057
(870) 946-4221
(870) 946-1181
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120942716
—
AR
Enumeration date
01/31/2007
Last updated
10/20/2011
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