Provider Demographics
NPI:1053165563
Name:COLLIER DRUG STORES INC
Entity type:Organization
Organization Name:COLLIER DRUG STORES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF 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:PO BOX 1085
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72702-1085
Mailing Address - Country:US
Mailing Address - Phone:479-935-4303
Mailing Address - Fax:479-521-9111
Practice Address - Street 1:112 S DIXIELAND ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:AR
Practice Address - Zip Code:72745-8655
Practice Address - Country:US
Practice Address - Phone:479-935-4303
Practice Address - Fax:479-521-9111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy