Organization
FOREMAN PHARMACY INC
Active
Other names
FOREMAN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH WATTENBARGER (PRESIDENT/OWNER)
(870) 542-6544
Entity
Organization
Contact information
Practice address
106 SCHUMAN ST, FOREMAN, AR 71836
(870) 542-6544
(870) 542-7525
Mailing address
PO BOX 86, FOREMAN, AR 71836-0086
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20353
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0402797
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
149077407
—
AR
Enumeration date
10/23/2006
Last updated
10/30/2011
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