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Organization

S&W PHARMACY, INC.

Active
Other names
USA DRUG #3
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GARY M. BOONE (DIRECTOR OF HME OPERATIONS)
(479) 394-6363
Entity
Organization

Contact information

Practice address
437 E PAGE AVE, MALVERN, AR 72104-4249
(501) 332-2771
(501) 332-2846
Mailing address
2100 BROOKWOOD DR, LITTLE ROCK, AR 72202-1734

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
AR06961
AR
333600000X
Pharmacy
AR06961
AR
3336C0003X
Community/Retail Pharmacy
Primary
3336L0003X
Long Term Care Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0406961
OTHER ID NUMBER-COMMERCIAL NUMBER
05
100295407
AR
01
10618
MEDICARE FLU
AR
01
135681716
MEDICAID DME
AR
Enumeration date
10/25/2006
Last updated
10/30/2008
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