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Organization

CAEVERETT, INC

Active
Other names
CORNER DRUG STORE
Organization subpart
No

Provider details

NPI number
Authorized official
ABBY EVERETT PHARMD (OWNER/PIC)
(870) 368-7171
Entity
Organization

Contact information

Practice address
830 E MAIN ST, MELBOURNE, AR 72556
(870) 368-7171
(870) 368-5295
Mailing address
PO BOX 1370, MELBOURNE, AR 72556-1370
(870) 368-7171
(870) 368-5295

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0426468
NCPDP
05
158762407
AR
05
237991407
AR
Enumeration date
03/22/2019
Last updated
05/13/2020
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