Organization
NYAL DRUG STORE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY LEE SHINABERY PD (OWNER)
(870) 358-2135
Entity
Organization
Contact information
Practice address
42 FRISCO ST, MARKED TREE, AR 72365-2214
(870) 358-2135
(870) 358-4055
Mailing address
42 FRISCO ST, MARKED TREE, AR 72365-2214
(870) 358-2135
(870) 358-4055
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6039
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0404575
NATIONAL PHARMACY NUMBER
AR
Enumeration date
07/21/2006
Last updated
08/06/2007
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