Organization
MONTICELLO DRUG COMPANY LLC
Active
Other names
City Drug
Organization subpart
No
Provider details
NPI number
Authorized official
KHALIL LYNN CROUSE (OWNER/PHARMD)
(870) 265-2220
Entity
Organization
Contact information
Practice address
201 EAST GAINES, MONTICELLO, AR 71655
(870) 367-5301
(870) 460-0257
Mailing address
201 E GAINES ST, MONTICELLO, AR 71655-4903
(870) 367-5301
(870) 460-0257
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
AR11936
AR
3336C0003X
Community/Retail Pharmacy
Primary
AR11936
AR
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187711407
—
AR
Enumeration date
09/27/2006
Last updated
09/29/2025
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