Organization
MITCHELLS PARK STREET PHARMACY INC
Active
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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