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Contact Information

MONTICELLO DRUG COMPANY LLC
201 EAST GAINES
MONTICELLO, AR71655
 Phone: 870-367-5301
 Fax: 870-460-0257
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for MONTICELLO DRUG COMPANY LLC

NPI # 1740371475
LBN Legal business name MONTICELLO DRUG COMPANY LLC
Authorized official KHALIL CROUSE - (OWNER/PHARMD)
Entity Organization
Organization subpart 1 No
Enumeration date 09/27/2006
Last updated 09/29/2025 - About 8 months ago
Identifiers
AR License # AR11936
AR Medicaid 187711407
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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