Organization
FONGS DRUGS
Active
Other names
FONGS DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE FONG PHRM (OWNER)
(870) 792-8763
Entity
Organization
Contact information
Practice address
621 COMMERCE ST, EARLE, AR 72331-1616
(870) 792-8763
(870) 792-8210
Mailing address
PO BOX 513, MILLINGTON, TN 38083-0513
(870) 792-8763
(870) 792-8210
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR02507
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0402507
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
100280407
—
AR
Enumeration date
10/25/2006
Last updated
11/10/2010
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