Organization
NW CARTHAGE LLC
Active
Other names
Express Rx of Carthage
Organization subpart
No
Provider details
NPI number
Authorized official
GALEN PERKINS (CEO)
(501) 258-4399
Entity
Organization
Contact information
Practice address
1601 MISSOURI AVE, CARTHAGE, MO 64836-3060
(417) 359-8185
(417) 359-8276
Mailing address
PO BOX 34407, PMB 53760, LITTLE ROCK, AR 72203-4407
(501) 534-4459
(501) 534-4460
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2013012689
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140170
PK
—
05
—
600005462
—
MO
Enumeration date
04/22/2013
Last updated
04/27/2023
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