Organization
BOBBY TEETERS DRUG STORE INC
Active
Organization
BOBBY TEETERS DRUG STORE INC
Active
Other names
BOBBY TEETERS DRUG STORE INC
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT TEETER PD (OWNER PIC)
(479) 754-2196
Entity
Organization
Contact information
Practice address
200 W MAIN ST, CLARKSVILLE, AR 72830-3010
(479) 754-2196
(479) 754-8885
Mailing address
200 W MAIN ST, CLARKSVILLE, AR 72830-3010
(479) 754-2196
(479) 754-8885
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR11847
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0411847
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
100098407
—
AR
Enumeration date
10/03/2006
Last updated
07/18/2011
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