Provider Demographics
NPI:1881456937
Name:MCKENNEY PHARMACY, LLC
Entity type:Organization
Organization Name:MCKENNEY PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:MCKENNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:870-324-5310
Mailing Address - Street 1:264 N 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:PIGGOTT
Mailing Address - State:AR
Mailing Address - Zip Code:72454-2009
Mailing Address - Country:US
Mailing Address - Phone:870-324-5310
Mailing Address - Fax:870-324-5311
Practice Address - Street 1:264 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:PIGGOTT
Practice Address - State:AR
Practice Address - Zip Code:72454-2009
Practice Address - Country:US
Practice Address - Phone:870-324-5310
Practice Address - Fax:870-324-5311
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCKENNEY PHARMACY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy