NW OTTER CREEK LLC (NPI# 1285167502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285167502 |
| Entity Type | Organization |
| Organization Name | NW OTTER CREEK LLC |
| Other Organization Name | EXPRESS RX AT OTTER CREEK |
| Practice Address |
10100 Stagecoach Rd Little Rock AR 72210-5742 |
| Mailing Address |
Po Box 7791 Little Rock AR 72217-7791 |
| Practice Telephone | 5014552522 |
| Mailing Telephone | 8555539777 |
| Mailing Fax Number | 5012463842 |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2020-05-21 |
| Authorized Official Name | JOHN TRAINOR NAMIR (CFO) |
| Authorized Official Telephone | 5017730359 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 221379407 | 05 |
| Other Name | Type Code |
|---|---|
| Express Rx at Otter Creek | Doing Business As Name - Organization |
| Street Address |
10100 STAGECOACH RD |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72210-5742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487290888 | John Hunter Bramlitt | Counselor | 12320 I-30, Little Rock, AR 72210 | 2019-11-20 |
| 1972159267 | Arkansas Baptist Children's Homes and Family Ministries | Counselor | 12400 I-30, Little Rock, AR 72210 | 2019-08-13 |
| 1952956864 | Hanrietta Evans | Behavior Technician | Youth Home Inc, 20302 Colonel Glenn Rd, Little Rock, AR 72210 | 2019-08-07 |
| 1821597287 | Deanna Smith | Counselor | 12320 I-30 Frontage Road, Little Rock, AR 72210 | 2018-02-12 |
| 1922485481 | Whitney Brown | Social Worker | 20400 Colonel Glenn, Little Rock, AR 72210 | 2015-05-04 |
| 1679978191 | Jennifer Black | Counselor | 20302 Col Glenn Road, Little Rock, AR 72210 | 2014-10-27 |
| 1831593896 | James William Takach | Family Medicine | 14519 Wimbledon Loop, Little Rock, AR 72210 | 2014-10-20 |
| 1811319734 | Ben Malone | Case Manager/Care Coordinator | 20400 Col Glenn Road, Little Rock, AR 72210 | 2014-01-12 |
| 1487924296 | Tara Brown | Case Manager/Care Coordinator | 20302 Colonel Glenn Rd., Little Rock, AR 72210 | 2012-01-10 |
| 1972889061 | D. Rachelle Rial | Case Manager/Care Coordinator | 20400 Col Glenn Rd., Little Rock, AR 72210 | 2011-11-02 |
| Find all providers in zip 72210 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457978157 | Sc Pharmacy Group Opco LLC | Pharmacy | 1800 Riverfront Dr Ste 100, Little Rock, AR 72202-1882 | 2020-06-29 |
| 1972023240 | Medicine Man Pharmacy - Little Rock, Inc | Pharmacy | 400 N Bowman Rd Ste 31, Little Rock, AR 72211-2733 | 2017-06-27 |
| 1619374360 | Cjn Pharmacy Services LLC | Pharmacy | 400 N Bowman Rd Ste 19, Little Rock, AR 72211-2733 | 2014-11-24 |
| 1063834380 | Pharmacy of Otter Creek | Pharmacy | 10506 Stagecoach Rd Ste F, Little Rock, AR 72210-8939 | 2014-01-07 |
| 1366706244 | Allcare Specialty Pharmacy LLC | Pharmacy | 10620 Colonel Glenn Rd Ste 300, Little Rock, AR 72204-8048 | 2012-06-26 |
| 1548575814 | Arkansas Cvs Pharmacy LLC | Pharmacy | 420 S University Ave, Little Rock, AR 72205-5246 | 2010-08-11 |
| 1760629984 | Stagecoach Pharmacy LLC | Pharmacy | 1 Stagecoach Vlg, Ste 2, Little Rock, AR 72210-4750 | 2009-01-09 |
| 1174671176 | Supermarket Investors Inc | Pharmacy | 1701 Main St, Little Rock, AR 72206-1471 | 2007-01-08 |
| 1700934700 | Supermarket Investors Inc | Pharmacy | 2510 Cantrell Rd, Little Rock, AR 72202-2116 | 2007-01-08 |
| 1083762082 | Supermarket Investors Inc | Pharmacy | 10320 Stagecoach Rd, Little Rock, AR 72210-5746 | 2007-01-08 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72210 |
Please comment or provide details below to improve the information on NW OTTER CREEK 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.