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Suppliers Pharmacy

Provider NPI: 1376048124

Organization Information:
Organization is not Subpart
Authorized Official:  LAURA  BARI  COOWNER  870-972-8310

Practice Location:
10040 HIGHWAY 63 S STE 4  BONO, AR 72416-8669 US
Tel: 870-277-1543  Fax: 870-277-1527

Business Mailing Address:
10040 HIGHWAY 63 S STE 4  BONO, AR 72416-8669 US
Tel: 870-277-1543  Fax: 870-277-1527

NPI Information:
NPI: 1376048124
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 3336C0003X





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