Organization
LYON DRUG COMPANY MAUMELLE INC
Active
Other names
Bradley's Healthmart
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT BRADLEY RPH (PRESIDENT/OWNER/PIC)
(501) 553-3604
Entity
Organization
Contact information
Practice address
1900 CLUB MANOR DR STE 101, MAUMELLE, AR 72113-7443
(501) 803-9400
(501) 803-9441
Mailing address
1900 CLUB MANOR DR STE 101, MAUMELLE, AR 72113-7443
(501) 803-9400
(501) 803-9441
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20638
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186574407
—
AR
01
—
2127857
PK
—
Enumeration date
11/11/2010
Last updated
04/05/2017
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