ARKANSAS CVS PHARMACY, LLC (NPI# 1023492154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023492154 |
| Entity Type | Organization |
| Organization Name | ARKANSAS CVS PHARMACY, LLC |
| Other Organization Name | CVS PHARMACY #10518 |
| Practice Address |
825 Oak St Conway AR 72032-4407 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 5013368684 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2016-04-29 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR-PAYER RELATIONS) |
| Authorized Official Telephone | 4017651500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | AR | Suppliers | |
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
AR | Suppliers | |
| Y | 333600000X | Pharmacy | AR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | DME | 212665716 | 01 |
| AR | NCPDP | 0425303 | 01 |
| AR | 210562407 | 05 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #10518 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437609369 | Arkansas Cvs Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 1749 W Walnut St, Rogers, AR 72756-3323 | 2016-10-04 |
| 1427432558 | Arkansas Cvs Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 3630 Central Ave, Hot Springs, AR 71913-6403 | 2015-07-18 |
| Street Address |
825 OAK ST |
| City | CONWAY |
| State | AR |
| Zip Code | 72032-4407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326388901 | Pamela Annette Moss | Pharmacist | 825 Oak St, Conway, AR 72032-4407 | 2013-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730789843 | Amelia S Lasater | Pharmacist | 1155 Hwy 65n, Conway, AR 72032 | 2020-10-28 |
| 1619584604 | Danyelle Durocher | Occupational Therapist | 1301 North Museum Rd, Conway, AR 72032 | 2020-09-24 |
| 1780222174 | Eric Herman Boxnick | Pharmacist | 101 West Oak Street, Conway, AR 72032 | 2019-12-16 |
| 1932746070 | Habilitation Center, LLC | Psychiatric Residential Treatment Facility | 161 Skunk Hollow Road, Conway, AR 72032 | 2019-12-09 |
| 1679051668 | Mary Elizabeth Black | Nurse Practitioner | 222 Dave Ward Drive, Conway, AR 72032 | 2018-08-01 |
| 1275035602 | Conway Dental Center Pllc | Dentist | 1600 E. Oak Street Suite B, Conway, AR 72032 | 2018-03-01 |
| 1750821625 | Luke Osborne | Physical Therapy Assistant | 1 Thomas Ln, Conway, AR 72032 | 2017-02-27 |
| 1639620099 | Sam's West, Inc. | Technician/Technologist | 1250 South Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1922559343 | Sam's West, Inc. | Durable Medical Equipment & Medical Supplies | 1250 Sourth Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1639629108 | Posture Store | Durable Medical Equipment & Medical Supplies | 3900 Dave Ward Dr., Suite 1900-130, Conway, AR 72032 | 2016-10-09 |
| Find all providers in zip 72032 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013422179 | Ppg Store 6 LLC | Pharmacy | 2235 Dave Ward Dr Ste 108, Conway, AR 72034-7040 | 2017-12-11 |
| 1386095982 | Conway Medical Park Pharmacy | Pharmacy | 650 United Dr Ste 110, Conway, AR 72032-7000 | 2016-06-24 |
| 1821335845 | 3bg, Inc. | Pharmacy | 810 Amity Rd, Suite 101, Conway, AR 72032-5988 | 2013-01-10 |
| 1760682108 | S.c. Department of Health and Environmental Control | Pharmacy | 1931 Industrial Park Road, Conway, SC 29526 | 2007-07-24 |
| 1326072174 | Kroger Limited Partnership I | Pharmacy | 855 Salem Rd, Conway, AR 72034-4820 | 2006-07-10 |
| 1447282470 | Freds Stores of Tennessee Inc | Pharmacy | 245 East Oak Street, Conway, AR 72032 | 2006-07-07 |
| 1205876059 | Pharmacy Solutions Inc | Pharmacy | 2125 College Ave, Suite 2, Conway, AR 72034 | 2006-06-08 |
| 1306843016 | Baker Drug Company | Pharmacy | 924 Front St, Conway, AR 72032-4304 | 2005-07-07 |
| 1659916344 | Walmart Pharmacy | Pharmacy | 2709 Church St Ste A, Conway, SC 29526-4440 | 2019-11-17 |
| 1174969935 | S.c. Department of Health and Environmental Control | Pharmacy | 1931 Industrial Park Rd, Conway, SC 29526-5482 | 2013-05-20 |
| Find all providers in CONWAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.