Provider Demographics
NPI:1265413843
Name:T&C WATSON INC
Entity type:Organization
Organization Name:T&C WATSON INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:501-470-3773
Mailing Address - Street 1:582 HIGHWAY 365
Mailing Address - Street 2:SUITE B
Mailing Address - City:MAYFLOWER
Mailing Address - State:AR
Mailing Address - Zip Code:72106-9524
Mailing Address - Country:US
Mailing Address - Phone:501-470-3773
Mailing Address - Fax:501-470-4412
Practice Address - Street 1:582 HIGHWAY 365
Practice Address - Street 2:SUITE B
Practice Address - City:MAYFLOWER
Practice Address - State:AR
Practice Address - Zip Code:72106-9524
Practice Address - Country:US
Practice Address - Phone:501-470-3773
Practice Address - Fax:501-470-4412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1302410001Medicare ID - Type Unspecified