Active NPI
Manpreet Kaur Ghotra
- Pharmacist
- Pine Bluff, AR
National Provider Identifier
1013695766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD16650
- Practice address
- 5905 Dollarway Rd
Pine Bluff, AR 71602-3825 - Phone
- (870) 534-7868
- NPI assigned
- Jul 11, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PD16650 | AR | Primary |
Addresses
Primary practice location
5905 Dollarway Rd
Pine Bluff, AR 71602-3825
Mailing address
604 Meredith St
White Hall, AR 71602-2913
Phone (347) 475-6697
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PD16650 | AR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
5905 Dollarway Rd
White Hall, AR 71602
Phone (870) 534-7868
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689033600000",
"number": "1013695766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "604 MEREDITH ST",
"city": "WHITE HALL",
"state": "AR",
"postal_code": "716022913",
"telephone_number": "347-475-6697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5905 DOLLARWAY RD",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716023825",
"telephone_number": "870-534-7868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHOTRA",
"first_name": "MANPREET",
"middle_name": "KAUR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-11",
"last_updated": "2023-07-11",
"certification_date": "2023-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD16650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pine Bluff, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.