Organization
HYDE PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH ROBERT KUENZEL PHARM D (PRESIDENT)
(870) 239-4036
Entity
Organization
Contact information
Practice address
1001 W KINGSHIGHWAY, PARAGOULD, AR 72450
(870) 239-4036
(870) 239-9478
Mailing address
1001 W KINGSHIGHWAY, PARAGOULD, AR 72450-4142
(870) 239-4036
(870) 239-9478
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
AR16734
AR
3336L0003X
Long Term Care Pharmacy
AR16734
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117466407
—
AR
Enumeration date
07/23/2006
Last updated
03/15/2024
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