Provider Demographics
NPI:1245064815
Name:CALHOUN COUNTY PHARMACY LLC
Entity type:Organization
Organization Name:CALHOUN COUNTY PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-642-2620
Mailing Address - Street 1:344 S. LEE ST
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:AR
Mailing Address - Zip Code:71744-8601
Mailing Address - Country:US
Mailing Address - Phone:870-798-4247
Mailing Address - Fax:870-798-4934
Practice Address - Street 1:344 S. LEE ST
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:AR
Practice Address - Zip Code:71744-8601
Practice Address - Country:US
Practice Address - Phone:870-798-4247
Practice Address - Fax:870-798-4934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy