Provider Demographics
NPI:1336208602
Name:BRUCE DRUGS INC
Entity Type:Organization
Organization Name:BRUCE DRUGS INC
Other - Org Name:EDGAR FLOYD HENLEY PROPERTYS BRUCE DRUGS INC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ED.
Authorized Official - Middle Name:F
Authorized Official - Last Name:HENLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:870-863-9867
Mailing Address - Street 1:711 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:SMACKOVER
Mailing Address - State:AR
Mailing Address - Zip Code:71762-1822
Mailing Address - Country:US
Mailing Address - Phone:870-725-2401
Mailing Address - Fax:870-725-2853
Practice Address - Street 1:711 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SMACKOVER
Practice Address - State:AR
Practice Address - Zip Code:71762-1822
Practice Address - Country:US
Practice Address - Phone:870-725-2401
Practice Address - Fax:870-725-2853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR04061013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR0406101OtherPHARMACY ID