Provider Demographics
NPI:1982388294
Name:EUDORA PHARMACY INC
Entity Type:Organization
Organization Name:EUDORA PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CALLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNEMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-265-2220
Mailing Address - Street 1:PO BOX 552
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71653-0552
Mailing Address - Country:US
Mailing Address - Phone:870-265-2220
Mailing Address - Fax:870-265-2226
Practice Address - Street 1:200 S MAIN ST
Practice Address - Street 2:
Practice Address - City:EUDORA
Practice Address - State:AR
Practice Address - Zip Code:71640-3061
Practice Address - Country:US
Practice Address - Phone:870-355-2046
Practice Address - Fax:870-355-2444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy