Organization
MITCHELLS PARK STREET PHARMACY INC
Active
Other names
MITCHELLS PARK STREET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH MITCHELL PHARM D (PRESIDENT)
(870) 297-8107
Entity
Organization
Contact information
Practice address
526 PARK ST, CALICO ROCK, AR 72519-9070
(870) 297-8107
(870) 297-8799
Mailing address
PO BOX 569, CALICO ROCK, AR 72519-0569
(870) 297-8107
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20214
AR
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100056407
—
AR
01
—
1994893
PK
—
Enumeration date
09/23/2005
Last updated
07/05/2016
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