Provider Demographics
NPI:1942984752
Name:DLSN LLC
Entity Type:Organization
Organization Name:DLSN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/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:
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:
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?:Yes
Parent Organization LBN:DLSN LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy