FOUNTAIN LAKE FAMILY PHARMACY LLC (NPI# 1164081071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164081071 |
| Entity Type | Organization |
| Organization Name | FOUNTAIN LAKE FAMILY PHARMACY LLC |
| Practice Address |
4517 Park Ave Suite B Hot Springs AR 71901 |
| Practice Telephone | 5015473400 |
| Practice Fax Number | 8448057790 |
| Mailing Telephone | 5015473400 |
| Mailing Fax Number | 8448057790 |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2020-07-21 |
| Authorized Official Name | MICHAEL DAVID BUTLER (OWNER) |
| Authorized Official Telephone | 5015473400 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| Street Address |
4517 PARK AVE SUITE B |
| City | HOT SPRINGS |
| State | AR |
| Zip Code | 71901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821049453 | Richard Ross Finch | Family Medicine | 4517 Park Ave, Hot Springs, AR 71901-9476 | 2006-05-16 |
| 1710340088 | Gregory Sketas IIi | Family Medicine | 4517 Park Ave, Hot Springs, AR 71901 | 2016-04-03 |
| 1912208067 | Alisha Kristen Ashley | Nurse Practitioner | 4517 Park Ave, Hot Springs, AR 71901-9476 | 2010-11-05 |
| 1467763110 | Stephanie Ann Ragsdale | Nurse Practitioner | 4517 Park Ave, Hot Springs, AR 71901-9476 | 2010-06-28 |
| 1316279375 | Healthstar Physicians of Hot Springs, Pllc | Family Medicine | 4517 Park Ave, Hot Springs, AR 71901-9476 | 2010-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346878303 | Hot Springs Ambulatory Surgery Center, LLC | Clinic/Center | 148 Sawtooth Oak St, Hot Springs, AR 71901 | 2020-03-27 |
| 1114558285 | Patrick Michael Westerman | Physical Therapist | 2122 Malvern Ave, Suite 5, Hot Springs, AR 71901 | 2020-01-28 |
| 1013416601 | Cheryl Kuhn | Counselor | 1820 Central Ave. Ste. B, Hot Springs, AR 71901 | 2018-02-08 |
| 1841711744 | Bonnie Lee | Case Manager/Care Coordinator | 240 Matthews Dr Apt A2, Hot Springs, AR 71901 | 2017-06-29 |
| 1699221457 | Belvedere Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 2600 Park Avenue, Hot Springs, AR 71901 | 2016-08-31 |
| 1639558398 | Jamie L. Summers Stacks, Pa | Counselor | 100 Ridgeway Ave, Suite 1, Hot Springs, AR 71901 | 2015-05-27 |
| 1831435452 | Wpm Community Pharmacies, LLC | Pharmacist | 105 Sawtooth Oak Street, Hot Springs, AR 71901 | 2012-12-31 |
| 1467759159 | Karissia Dawson | Counselor | 100 Ridgeway St Ste 5, Hot Springs, AR 71901 | 2011-02-16 |
| 1407172331 | Summit Dental, Inc | Dentist | 1421 Central Avenue, Hot Springs, AR 71901 | 2010-04-16 |
| 1609190826 | Mindy Gallegos | Nurse Practitioner | 102 Chippewa Ct, Hot Springs, AR 71901 | 2010-03-17 |
| Find all providers in zip 71901 | ||||
| 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 |
|---|---|---|---|---|
| 1184053571 | Smith Drug and Compounding Inc | Pharmacy | 1629 Airport Rd Ste D, Hot Springs, AR 71913-8069 | 2013-11-06 |
| 1548528268 | Genoa Healthcare, LLC | Pharmacy | 125 Wellness Way Ste 268, Hot Springs, AR 71913-6478 | 2012-05-01 |
| 1801185574 | Lakeside Pharmacy Inc. | Pharmacy | 998 Shady Grove Rd Unit 1-h, Hot Springs, AR 71901-8094 | 2011-04-04 |
| 1134258882 | J B Stone Inc | Pharmacy | 107 Crawford St, Hot Springs, AR 71913-6136 | 2007-03-05 |
| 1386789709 | Family Drug Center Inc | Pharmacy | 510 Albert Pike Rd, Hot Springs, AR 71913-3814 | 2007-02-21 |
| 1386669083 | Kroger Limited Partnership I | Pharmacy | 215 Airport Rd, Hot Springs, AR 71913-4060 | 2006-07-13 |
| 1528092236 | Kroger Limited Partnership I | Pharmacy | 4407 Central Ave, Hot Springs, AR 71913-7253 | 2006-07-10 |
| 1093716029 | Bath County Community Hospital | Pharmacy | 2833 Main Street, Hot Springs, VA 24445 | 2005-08-01 |
| 1144561531 | Bcd Healthcare LLC | Pharmacy | 1340 Higdon Ferry Rd, Hot Springs, AR 71913-6411 | 2013-03-08 |
| 1699813683 | Dakotamart Inc | Pharmacy | 501 S 6th St, Hot Springs, SD 57747-2318 | 2007-02-02 |
| Find all providers in HOT SPRINGS | ||||
| City | HOT SPRINGS |
| Zip Code | 71901 |
Please comment or provide details below to improve the information on FOUNTAIN LAKE FAMILY PHARMACY LLC.
| 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.