Organization
MONTICELLO DRUG INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD KOEN PD (PRESIDENT)
(870) 367-6291
Entity
Organization
Contact information
Practice address
109 W GAINES ST, MONTICELLO, AR 71655-4717
(870) 367-6291
(870) 367-2403
Mailing address
109 W GAINES ST, MONTICELLO, AR 71655-4717
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
AR04804
AR
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0404804
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/17/2006
Last updated
09/11/2025
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