Organization
JIMMMYS PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES PRESTIDGE RPH (OWNER)
(870) 483-0400
Entity
Organization
Contact information
Practice address
1704 ST A WHY 69 BLVD, TRUMANN, AR 72472
(870) 483-0400
(870) 483-0409
Mailing address
1704 ST A WHY 69 BLVD, TRUMANN, AR 72472
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
AR20532
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0422395
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
05/12/2006
Last updated
08/22/2020
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