Organization
MONETTE DISCOUNT DRUG INC
Active
Organization
MONETTE DISCOUNT DRUG INC
Active
Other names
Leachville Discount Drug
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE ANDREW LOMAX PHARM. D. (PHARMACIST)
(870) 275-9496
Entity
Organization
Contact information
Practice address
109 S MAIN ST, LEACHVILLE, AR 72438-9097
(870) 539-6831
(870) 539-6681
Mailing address
PO BOX 82, 109 SOUTH MAIN, LEACHVILLE, AR 72438-0082
(870) 539-6831
(870) 539-6681
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR15744
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0415744
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
178642407
—
AR
05
—
602470908
—
MO
Enumeration date
01/16/2007
Last updated
03/07/2023
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