RED RIVER PHARMACY OF LITTLE ROCK (NPI# 1679129704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679129704 |
| Entity Type | Organization |
| Organization Name | RED RIVER PHARMACY OF LITTLE ROCK |
| Other Organization Name | RED RIVER VITAL CARE OF LITTLE ROCK |
| Practice Address |
1200 Business Park Dr Ste 1 Little Rock AR 72204-2698 |
| Mailing Address |
1550 Moores Ln Texarkana TX 75503-4657 |
| Practice Telephone | 5019078949 |
| Practice Fax Number | 5019076505 |
| Mailing Telephone | 5019078949 |
| Mailing Fax Number | 5019076505 |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2020-10-30 |
| Authorized Official Name | ROBIN BRULE (BUSINESS DIRECTOR) |
| Authorized Official Telephone | 9037927435 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
Suppliers | ||
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers |
| Other Name | Type Code |
|---|---|
| Red River Vital Care of Little Rock | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629525944 | Red River Pharmacy of Little Rock | Durable Medical Equipment & Medical Supplies | 1200 Business Park Dr Ste 1, Little Rock, AR 72204-2698 | 2016-09-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | RED RIVER PHARMACY OF LITTLE ROCK, LLC | 1200 Business Park Dr Ste 1, Little Rock, AR 72204-2698 |
| Street Address |
1200 BUSINESS PARK DR STE 1 |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72204-2698 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629525944 | Red River Pharmacy of Little Rock | Durable Medical Equipment & Medical Supplies | 1200 Business Park Dr Ste 1, Little Rock, AR 72204-2698 | 2016-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669952966 | Shane Wilson | Non-emergency Medical Transport (VAN) | 1522 S Tyler St, Little Rock, AR 72204 | 2018-08-16 |
| 1659858348 | Poplar Grove Operations LLC | Skilled Nursing Facility | 7801 Kanis Road, Little Rock, AR 72204 | 2018-07-25 |
| 1275056004 | University of Arkansas for Medical Sciences | Orthopaedic Surgery | 108015 Colonel Glenn Rd, Little Rock, AR 72204 | 2017-07-24 |
| 1265954820 | Marilyn Marie Lynch | Registered Nurse | 7723 Colonel Glenn Road, Little Rock, AR 72204 | 2017-07-14 |
| 1962852954 | Arkansas Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1122 S. University Ave, Little Rock, AR 72204 | 2016-06-21 |
| 1841607751 | Charity Gillespie | Registered Nurse | 5210 Timberland Dr, Little Rock, AR 72204 | 2014-07-14 |
| 1043625221 | Interventional Surgery Institute of Little Rock, LLC | Clinic/Center | 9 Freeway Drive, Suite A, Little Rock, AR 72204 | 2014-06-25 |
| 1548696065 | Jamie Washington | Prosthetic/Orthotic Supplier | 4701 Westwood Ave, Little Rock, AR 72204 | 2013-09-16 |
| 1124468913 | Stephanie Rachelle Jez | Genetic Counselor, MS | 5800 West 10th Street, Freeway Medical Building, Suite 7-500, Little Rock, AR 72204 | 2013-06-26 |
| 1336492321 | Alton Charles Phillips Sr. | Counselor | 4400shuffield Drive, Little Rock, AR 72204 | 2012-10-16 |
| Find all providers in zip 72204 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871143941 | Amber Williams | Durable Medical Equipment & Medical Supplies | 9101 Auxor Rd Apt C24, Little Rock, AR 72209-6884 | 2019-09-19 |
| 1053663062 | Contourmed | Durable Medical Equipment & Medical Supplies | 2217 Cottondale Ln, Little Rock, AR 72202-2018 | 2012-10-15 |
| 1629370317 | United Seating and Mobility LLC | Durable Medical Equipment & Medical Supplies | 1523 South Bowman Road, Suite A, Little Rock, AR 72211-4226 | 2010-12-01 |
| 1710155536 | Occupational Professional Sevices Inc. | Durable Medical Equipment & Medical Supplies | 509 North Valentine St., Little Rock, AR 72205-4135 | 2008-02-14 |
| 1467639096 | Universal Medical Supply Corp | Durable Medical Equipment & Medical Supplies | 801 S Bowman Rd, Suite 2, Little Rock, AR 72211-3433 | 2008-01-25 |
| 1699957928 | Alloplastic Facial Reconstruction | Durable Medical Equipment & Medical Supplies | 3924 W Markham St, Little Rock, AR 72205-5528 | 2007-11-28 |
| 1962440891 | Finnegans Inc | Durable Medical Equipment & Medical Supplies | 6805 W 12th St, Suite F, Little Rock, AR 72204-2401 | 2006-06-03 |
| 1487613329 | Arkansas Ostomy, Inc | Durable Medical Equipment & Medical Supplies | 16607 Cantrell Rd Ste 7, Little Rock, AR 72223-4247 | 2006-03-20 |
| 1356311849 | Cpo2 Inc | Durable Medical Equipment & Medical Supplies | 1519 S Bowman Rd Ste B, Little Rock, AR 72211 | 2006-01-25 |
| 1942561303 | Usable Corporation | Durable Medical Equipment & Medical Supplies | 601 S Gaines St, Little Rock, AR 72201-4007 | 2012-06-01 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72204 |
Please comment or provide details below to improve the information on RED RIVER PHARMACY OF LITTLE ROCK.
| 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.