Lake Village Drugstore, Inc.
LBN: Lake Village Drugstore, Inc.
Lake Village Drugstore, Inc. is an health care organization with primary practice located at 2907 Hwy 65-82 South , Lake Village AR 71653. The organization recently has 2 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Lake Village Drugstore, Inc. can be contacted via phone (870) 265-5555, or through Crouse, Kamila Lea via phone (870) 265-5555.
Contact Information
Primary practice address
2907 Hwy 65-82 South
Lake Village AR 71653
Phone: (870) 265-5555
Fax: (870) 265-3174
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 0403890 | Arkansas |
| Suppliers / Community/Retail Pharmacy | 3336C0003X |
Profile Details
| NPI number | 1487789400 |
|---|---|
| LBN Legal business name | Lake Village Drugstore, Inc. |
| DBA Doing business as | |
| Authorized official | Crouse, Kamila Lea PHARM. D. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 22nd, 2007 |
| Last updated | Sep 16th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487789400 | NPPES |
| Arkansas | MEDICAID | 100517407 |
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