Provider Demographics
NPI:1366511842
Name:NASHVILLE DRUG COMPANY
Entity type:Organization
Organization Name:NASHVILLE DRUG COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:PINEGAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-845-2722
Mailing Address - Street 1:100 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:71852-2406
Mailing Address - Country:US
Mailing Address - Phone:870-845-2722
Mailing Address - Fax:870-845-2891
Practice Address - Street 1:100 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:AR
Practice Address - Zip Code:71852-2406
Practice Address - Country:US
Practice Address - Phone:870-845-2722
Practice Address - Fax:870-845-2891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR13891183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR100401407Medicaid