Eudora Drug Store

LBN: Eudora Pharmacy Inc
Eudora Drug Store is an health care organization with primary practice located at 200 S Main St , Eudora AR 71640-3061. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Eudora Pharmacy Inc can be contacted via phone (870) 355-4448, or through Crouse, Khalil via phone (870) 355-4448.

Contact Information

Primary practice address
200 S Main St Eudora AR 71640-3061
Phone: (870) 355-4448
Fax: (870) 355-2444
Website:
Map and Directions
Authorized official contact:
Name: Crouse, Khalil RPH
Phone: (870) 355-4448

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X AR19689 Arkansas
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1275548828
LBN Legal business name Eudora Pharmacy Inc
DBA Doing business as Eudora Drug Store
Authorized official Crouse, Khalil RPH
Entity Organization
Organization subpart 1 No
Enumeration date Jul 30th, 2006
Last updated Mar 15th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275548828 NPPES
Other 1992912 PK
MEDICAID 160503407 PK

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