Provider Demographics
NPI:1730950775
Name:COLLIER DRUG STORES, INC.
Entity type:Organization
Organization Name:COLLIER DRUG STORES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-935-4303
Mailing Address - Street 1:100 W DICKSON ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-5219
Mailing Address - Country:US
Mailing Address - Phone:479-935-4303
Mailing Address - Fax:479-521-9111
Practice Address - Street 1:260 S GLENEAGLE DR STE B
Practice Address - Street 2:
Practice Address - City:CAVE SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72718-6022
Practice Address - Country:US
Practice Address - Phone:479-203-7014
Practice Address - Fax:833-702-2079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy