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MONTICELLO DRUG COMPANY LLC NPI 1063286607


NPI Information

NPI: 1063286607
Provider Name: MONTICELLO DRUG COMPANY LLC
Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

CLIA Number: 04D2284722

Address:
201 E GAINES ST
MONTICELLO, AR
ZIP 71655
Phone: (870) 367-5301
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MONTICELLO DRUG COMPANY LLC is a long term care pharmacy pharmacy in Monticello, AR. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. MONTICELLO DRUG COMPANY LLC NPI is 1063286607. The provider is registered as an organization entity type.

The provider's business location address is:

201 E GAINES ST
MONTICELLO, AR
ZIP 71655-903
Phone: (870) 367-5301
Fax: (870) 460-0257

The provider's authorized official is Khalil Crouse .
The authorized official title is Owner and has the following contact phone number (870) 265-2220.

The CLIA number assigned to this NPI record is 04D2284722 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/14/2023 and was last updated on 11/14/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336L0003XPharmacyLong Term Care PharmacyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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