Provider Demographics
NPI:1477650216
Name:C AND M LLC
Entity Type:Organization
Organization Name:C AND M LLC
Other - Org Name:MARKET STREET DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:
Authorized Official - Last Name:STIRLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-670-5098
Mailing Address - Street 1:404 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:HORSESHOE BEND
Mailing Address - State:AR
Mailing Address - Zip Code:72512-3871
Mailing Address - Country:US
Mailing Address - Phone:870-670-5098
Mailing Address - Fax:870-670-5905
Practice Address - Street 1:404 MARKET ST
Practice Address - Street 2:
Practice Address - City:HORSESHOE BEND
Practice Address - State:AR
Practice Address - Zip Code:72512-3871
Practice Address - Country:US
Practice Address - Phone:870-670-5098
Practice Address - Fax:870-670-5905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
ARAR162533336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0422547OtherNCPDP PROVIDER IDENTIFICATION NUMBER
AR161819407Medicaid