Provider Demographics
NPI:1710057898
Name:WPM COMMUNITY PHARMACIES LLC
Entity Type:Organization
Organization Name:WPM COMMUNITY PHARMACIES LLC
Other - Org Name:ALLCARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:W
Authorized Official - Middle Name:
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:
Authorized Official - Credentials:PD
Authorized Official - Phone:870-246-5553
Mailing Address - Street 1:PO BOX 524
Mailing Address - Street 2:518 CLAY ST
Mailing Address - City:ARKADELPHIA
Mailing Address - State:AR
Mailing Address - Zip Code:71923-0524
Mailing Address - Country:US
Mailing Address - Phone:870-246-5553
Mailing Address - Fax:870-246-6616
Practice Address - Street 1:107 E NORTH ST
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753-2822
Practice Address - Country:US
Practice Address - Phone:870-234-8120
Practice Address - Fax:870-234-2774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
ARAR095513336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1994034OtherPK
AR100640407Medicaid
AR100640407Medicaid