Organization
MITCHELLS PARK STREET PHARMACY INC
Active
Parent organization
AM DIAMONDS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AM DIAMONDS LLC
Authorized official
SARAH BETH MITCHELL PHARM D (PRESIDENT)
(870) 297-8107
Entity
Organization
Contact information
Practice address
526 PARK ST, CALICO ROCK, AR 72519-9070
(870) 297-8107
(870) 297-8799
Mailing address
PO BOX 569, CALICO ROCK, AR 72519-0569
(870) 297-8107
(870) 297-8799
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117614716
—
AR
Enumeration date
11/11/2005
Last updated
01/26/2011
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