Provider Demographics
NPI:1225759640
Name:DLSN LLC
Entity Type:Organization
Organization Name:DLSN LLC
Other - Org Name:BAKER DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:DALLAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:501-329-5626
Mailing Address - Street 1:924 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-4304
Mailing Address - Country:US
Mailing Address - Phone:501-329-5626
Mailing Address - Fax:501-329-1977
Practice Address - Street 1:924 FRONT ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-4304
Practice Address - Country:US
Practice Address - Phone:501-329-5626
Practice Address - Fax:501-329-1977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-05
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy