Organization
LANGSTON DRUG STORE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA LEA MILLER-MORRISON (PRESIDENT)
(417) 678-4136
Entity
Organization
Contact information
Practice address
1202 MAIN ST, VAN BUREN, AR 72956-4555
(479) 474-3431
(479) 474-0106
Mailing address
124 S MADISON AVE, AURORA, MO 65605-1427
(417) 678-4136
(417) 678-2014
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
AR20382
AR
3336L0003X
Long Term Care Pharmacy
AR20382
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0400678
NCPDP
AR
05
—
100246160A
—
OK
05
—
101120407
—
AR
05
—
139920718
—
AR
Enumeration date
10/20/2005
Last updated
01/22/2016
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