Provider Demographics
NPI:1831306489
Name:MEDI-QUIK DISCOUNT PHARMACY 3, INC.
Entity Type:Organization
Organization Name:MEDI-QUIK DISCOUNT PHARMACY 3, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:WOOLSEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:479-209-1255
Mailing Address - Street 1:406 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:AR
Mailing Address - Zip Code:72855-3920
Mailing Address - Country:US
Mailing Address - Phone:479-963-1555
Mailing Address - Fax:479-963-1560
Practice Address - Street 1:406 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:AR
Practice Address - Zip Code:72855-3920
Practice Address - Country:US
Practice Address - Phone:479-963-1555
Practice Address - Fax:479-963-1560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336L0003X
ARAR205583336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5933600001Medicare NSC