Provider Demographics
NPI:1740024835
Name:LONOKE HEALTH & WELLNESS PA
Entity type:Organization
Organization Name:LONOKE HEALTH & WELLNESS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PENNINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:PD
Authorized Official - Phone:501-676-2247
Mailing Address - Street 1:PO BOX 680
Mailing Address - Street 2:
Mailing Address - City:LONOKE
Mailing Address - State:AR
Mailing Address - Zip Code:72086-0680
Mailing Address - Country:US
Mailing Address - Phone:501-676-2247
Mailing Address - Fax:501-676-3833
Practice Address - Street 1:115 W FRONT ST
Practice Address - Street 2:
Practice Address - City:LONOKE
Practice Address - State:AR
Practice Address - Zip Code:72086-3117
Practice Address - Country:US
Practice Address - Phone:501-676-2247
Practice Address - Fax:501-676-3833
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LONOKE HEATH & WELLNESS PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy