NPIMap

Organization Active NPI

College Pharmacy Inc

  • Community/Retail Pharmacy
  • Magnolia, AR
National Provider Identifier
1023099660
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
AR20042 Issued in AR
Legal business name
COLLEGE PHARMACY INC
Practice address
211 E Stadium
Magnolia, AR 71753-2032
Phone
(870) 234-7292
Fax
(870) 234-4443
NPI assigned
Nov 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Authorized official

Name
Jeffrey PrinceNPI 1093439739
Title
Owner Phcst
Phone
(870) 234-7292

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X AR20042 AR Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

211 E Stadium
Magnolia, AR 71753-2032

Mailing address

211 E Stadium
Magnolia, AR 71753-2032
Phone (870) 234-7292

Other identifiers 3

IdentifierTypeStateIssuer
112438407MedicaidAR
1275361MedicaidLA
1994732OtherPK

Other names 1

  • PRINCE PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930093773 AR DME Supplier - PharmacyDME Supplier - Medical Supply Company 0244357366 Practice locations: Magnolia, AR

National Provider Directory

National Provider Directory
Tax ID family
College Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773187200000",
    "number": "1023099660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E STADIUM",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532032",
            "telephone_number": "870-234-7292",
            "fax_number": "870-234-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E STADIUM",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532032",
            "telephone_number": "870-234-7292",
            "fax_number": "870-234-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER PHCST",
        "authorized_official_telephone_number": "870-234-7292"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR20042",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112438407",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275361",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1994732",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRINCE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Magnolia, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; 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.