Organization
M & T VENTURES LLC
Active
Other names
Sam Alexander Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TARA WILLMOTT (PHARMD)
(870) 741-6511
Entity
Organization
Contact information
Practice address
127 N MAIN ST, HARRISON, AR 72601-4227
(870) 741-6511
(870) 365-0216
Mailing address
127 N MAIN ST, HARRISON, AR 72601-4227
(870) 741-6511
(870) 365-0216
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR14590
AR
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2126195
PK
—
Enumeration date
08/06/2010
Last updated
02/21/2017
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