Organization
TOMMYS REXALL DRUG COMPANY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOMMY GLENN BLACK P.D. (PHARMACIST)
(870) 946-4221
Entity
Organization
Contact information
Practice address
220 COURT SQ, DEWITT, AR 72042-2057
(870) 946-4221
(870) 946-1181
Mailing address
220 COURT SQ, DEWITT, AR 72042-2057
(870) 946-4221
(870) 946-1181
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
AR14071
AR
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100643407
—
AR
05
—
120942716
—
AR
Enumeration date
01/12/2007
Last updated
09/01/2017
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