Organization
MEDI SHOP PHARMACY
Active
Other names
Medi Shop Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT GEYER PHARM.D. (PHARMACIST)
(479) 394-7476
Entity
Organization
Contact information
Practice address
204 HIGHWAY 71 S, MENA, AR 71953-4638
(479) 394-3254
(479) 394-0235
Mailing address
204 HIGHWAY 71 S, MENA, AR 71953-4638
(479) 394-3254
(479) 394-0235
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20383
AR
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190453407
—
AR
01
—
2133056
PK
—
Enumeration date
11/28/2011
Last updated
03/17/2017
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