Organization
THOMAS E. WINNINGHAM
Active
Other names
Winningham Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS E. WINNINGHAM RPH (OWNER)
(501) 344-2763
Entity
Organization
Contact information
Practice address
232 W MAIN ST, BRADFORD, AR 72020-0130
(501) 344-2763
(501) 344-8383
Mailing address
PO BOX 130, 232 W MAIN ST, BRADFORD, AR 72020-0130
(501) 344-2763
(501) 344-8383
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
AR01834
AR
333600000X
Pharmacy
Primary
AR01834
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100499407
—
AR
01
—
118686716
MEDICAID DME
AR
Enumeration date
11/06/2006
Last updated
06/28/2012
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