Provider Demographics
NPI:1407985161
Name:T&C WATSON
Entity Type:Organization
Organization Name:T&C WATSON
Other - Org Name:MAYFLOWER FOOD & DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-470-3773
Mailing Address - Street 1:582 HIGHWAY 365
Mailing Address - Street 2:SUITE B
Mailing Address - City:MAYFLOWER
Mailing Address - State:AR
Mailing Address - Zip Code:72106-9524
Mailing Address - Country:US
Mailing Address - Phone:501-470-3773
Mailing Address - Fax:501-470-4413
Practice Address - Street 1:582 HIGHWAY 365
Practice Address - Street 2:SUITE B
Practice Address - City:MAYFLOWER
Practice Address - State:AR
Practice Address - Zip Code:72106-9524
Practice Address - Country:US
Practice Address - Phone:501-470-3773
Practice Address - Fax:501-470-4413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR201943336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR0420860OtherNABP