Organization Name: | MCCOY-TYGART DRUG STORE INC |
NPI Number: | 1073579843 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PHILLIP A TYGART (PHARMACIST,CORP.OFCER.) |
Mailing Address: | 821 N Rock St Sheridan |
State: | AR US |
Postal Code: | 721507623 |
Phone Number: | 8709425121 |
Fax Number: | 8709422592 |
NPI Enumeration Date: | 04/21/2006 |
NPI Last Update Date: | 02/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | AR06048 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AR |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |