NPIMap

Organization Active NPI

Collier Drug Stores Inc

Doing business as Collier Drug-Prairie Grove

  • Community/Retail Pharmacy
  • Prairie Grove, AR
National Provider Identifier
1003816174
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
AR20282 Issued in AR
Legal business name
COLLIER DRUG STORES INC
Doing business as
Collier Drug-Prairie Grove
Practice address
801 E Douglas St
Prairie Grove, AR 72753-2737
Phone
(479) 846-2195
Fax
(479) 846-2147
NPI assigned
Jul 29, 2005
Last updated
Sep 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mel Collier
Title
Owner
Phone
(479) 442-6262

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X AR20282 AR Primary
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

801 E Douglas St
Prairie Grove, AR 72753-2737

Mailing address

PO Box 1085
Fayetteville, AR 72702-1085
Phone (479) 442-6262

Other identifiers 2

IdentifierTypeStateIssuer
1994219OtherPK
145056407MedicaidAR

Other names 1

  • COLLIER DRUG-PRAIRIE GROVE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110207000110 AR Part B Supplier - Mass Immunization (Roster Biller Only) 5294889358 12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tontitown, AR; Prairie Grove, AR; Lowell, AR; Johnson, AR; Fayetteville, AR; Farmington, AR; Elkins, AR; Centerton, AR…

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Collier Drug Stores Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1003816174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1085",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727021085",
            "telephone_number": "479-442-6262",
            "fax_number": "479-521-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E DOUGLAS ST",
            "city": "PRAIRIE GROVE",
            "state": "AR",
            "postal_code": "727532737",
            "telephone_number": "479-846-2195",
            "fax_number": "479-846-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLIER DRUG STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-29",
        "last_updated": "2025-09-19",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "COLLIER",
        "authorized_official_first_name": "MEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-442-6262"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR20282",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1994219",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145056407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COLLIER DRUG-PRAIRIE GROVE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "COLLIER DRUG-PRAIRIE GROVE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prairie Grove, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.