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MR. LARRY EUGENE TALLEY R.PH.

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1386708733

Individual Registrant:
MR. LARRY EUGENE TALLEY R.PH.
Gender: M
Sole Proprietor

Location and contact information for practice:
991 W CENTERTON BLVD  CENTERTON, AR 72719-8707 US
Tel: 479-795-8199  Fax: 479-795-8196

Contact information for business:
3618 N DIXIELAND RD  ROGERS, AR 72756-7002 US
Tel: 479-936-7586  Fax: --

Registration Information:
NPI: 1386708733
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
ARPD08774

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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