S L GARDNER INC (NPI# 1811003338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811003338 |
| Entity Type | Organization |
| Organization Name | S L GARDNER INC |
| Other Organization Name | CORNER DRUG STORE |
| Practice Address |
830 E Main St Melbourne AR 72556 |
| Mailing Address |
Po Box 1370 Melbourne AR 72556-1370 |
| Practice Telephone | 8703687171 |
| Practice Fax Number | 8703685295 |
| Mailing Telephone | 8703687171 |
| Mailing Fax Number | 8703685295 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2014-08-07 |
| Authorized Official Name | LISA M GARDNER (OWNER) |
| Authorized Official Telephone | 8703687171 |
| Authorized Official Credential | PHARM D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
AR11366 | AR | Suppliers |
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | SALES TAX PERMIT | 290317-33-001 | 01 |
| DEA | BB9501962 | 01 | |
| AR | 159450716 | 05 | |
| AR | BCBS | 47636 | 01 |
| Other Name | Type Code |
|---|---|
| CORNER DRUG STORE | Doing Business As Name - Organization |
| Street Address |
830 E MAIN ST |
| City | MELBOURNE |
| State | AR |
| Zip Code | 72556 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588124770 | Caeverett, Inc | Pharmacy | 830 E Main St, Melbourne, AR 72556 | 2019-03-22 |
| 1063406833 | Lisa M Gardner | Pharmacist | 830 E Main St, Melbourne, AR 72556-1370 | 2005-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275143950 | Brad Wheelis Family Dentistry Pllc | Clinic/Center | 1218 East Main St, Melbourne, AR 72556 | 2020-08-06 |
| 1932742640 | Abby Everett | Pharmacist | 803 E Main Street, Melbourne, AR 72556 | 2019-10-25 |
| 1154849065 | Baxter Regional Health System | Nurse Practitioner | 1019 East Main Street, Melbourne, AR 72556 | 2017-08-31 |
| 1265955512 | Kids El Melbourne | Pediatrics | 889 East Main, Melbourne, AR 72556 | 2017-07-19 |
| 1245752070 | Morgan Brittany Shirley | Nurse Practitioner | 1019 E. Main St., Melbourne, AR 72556 | 2017-07-13 |
| 1467988725 | Anita Love | Case Manager/Care Coordinator | 637 Esat Main St, Melbourne, AR 72556 | 2017-05-05 |
| 1558729236 | Regan Tharp | Developmental Therapist | 889 E. Main, Melbourne, AR 72556 | 2016-02-09 |
| 1740693274 | Richard Thomas Keefer | Social Worker | 637 East Main St, Melbourne, AR 72556 | 2014-06-02 |
| 1164858437 | Mary Grice Duncan | Pharmacist | 600 N. Main Street, Suite C, Melbourne, AR 72556 | 2013-09-18 |
| 1265871248 | Kidspiration Pediatric Therapy Services Too, Inc. | Clinic/Center | 905 East Main St, Melbourne, AR 72556 | 2013-06-23 |
| Find all providers in zip 72556 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588201347 | Florida Mobility Solutions LLC | Durable Medical Equipment & Medical Supplies | 268 N Wickham Rd, Melbourne, FL 32935-8625 | 2019-11-28 |
| 1952942849 | Alphamedics Inc | Durable Medical Equipment & Medical Supplies | 1101 W Hibiscus Blvd Ste 203, Melbourne, FL 32901-2719 | 2019-10-02 |
| 1720578420 | Sunmed Health Group Inc | Durable Medical Equipment & Medical Supplies | 1101 W Hibiscus Blvd Ste 106b, Melbourne, FL 32901-2700 | 2018-05-17 |
| 1275901191 | Orthotic & Prosthetic Centers, Inc. | Durable Medical Equipment & Medical Supplies | 47 W New Haven Ave Ste 102, Melbourne, FL 32901-4477 | 2015-09-09 |
| 1265754402 | Holiday Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 5590 N Wickham Rd, Melbourne, FL 32940-7303 | 2010-02-15 |
| 1801035118 | Personal Healthcare Products Inc. | Durable Medical Equipment & Medical Supplies | 2092 Sarno Rd, Melbourne, FL 32935-3077 | 2009-02-10 |
| 1811174469 | Uptown Medical | Durable Medical Equipment & Medical Supplies | 450 Distribution Dr, Suite 101, Melbourne, FL 32904-1176 | 2008-01-25 |
| 1841472479 | John D Mackenney Pa | Durable Medical Equipment & Medical Supplies | 6550 N Wickham Rd Ste 4, Melbourne, FL 32940-2038 | 2007-12-05 |
| 1194864850 | East Coast Orthotics Inc | Durable Medical Equipment & Medical Supplies | 129 W Hibiscus Blvd Ste N, Melbourne, FL 32901-3006 | 2007-02-06 |
| 1669546552 | Hanger Prosthetics & Orthotics Inc | Durable Medical Equipment & Medical Supplies | 737 S Apollo Blvd, Melbourne, FL 32901-1457 | 2006-11-20 |
| Find all providers in MELBOURNE | ||||
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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.