04D2294783 CLIA NUMBER - GREENWOOD PHARMACY

Laboratory Demographics

CLIA Number: 04D2294783

Facility Name: GREENWOOD PHARMACY

Facility Address:
560 W CENTER STREET
GREENWOOD, AR
ZIP 72936
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Facility Phone Number: 479 996-2000

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1467213629

Taxonomy: 3336L0003X - Pharmacy
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.

CLIA Record

Field Name	Field Value
CLIA Number	04D2294783
LAB Type	Pharmacy
Facility Name	GREENWOOD PHARMACY
Street	560 W CENTER STREET
City	GREENWOOD
State	AR
ZIP	72936
Phone	479 996-2000
CertificateType	4
CertificateEffectiveDate	11/30/2023
CertificateExpirationDate	11/29/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024