McKinney Drug Stores Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

AR20731 Issued in AR

Legal business name

MCKINNEY DRUG STORES INC

Doing business as

Community Pharmacy of Springdale

Practice address

400 W Emma Ave
Springdale, AR 72764-4471

Phone

(479) 750-2220

Fax

(479) 750-2031

NPI assigned

Oct 3, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Victoria Hennessey, PHARM.D.

Title

Owner/Pharmacist in Charge

Phone

(479) 750-2220

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Community Pharmacy of Springdale Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Tax ID family

Community Pharmacy of Springdale2 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.

• McKinney Drug Store Inc

  • Long Term Care Pharmacy
  • Springdale, AR
  • NPI 1619753241
  NPD tax ID

Locations

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598486400000",
    "number": "1023445293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W EMMA AVE",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727644471",
            "telephone_number": "479-750-2220",
            "fax_number": "479-750-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W EMMA AVE",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727644471",
            "telephone_number": "479-750-2220",
            "fax_number": "479-750-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKINNEY DRUG STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-03",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "HENNESSEY",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "OWNER/PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "479-750-2220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR20731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142345",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Pharmacy of Springdale",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Pharmacy of Springdale",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Korey McKelvy
• Rachel A McKelvy, M.D.
• Sarah E McKenna, LPC
• Lisa McKeown
• McKinney Drug Store Inc
• McKinney Drug Stores Inc
• Brandon McKinney
• Nancy Lynn McKown, RN
• Kaley Mahree McManamon
• Brad William McMullin, RN

• Community/Retail Pharmacy in Springdale, AR
• Providers in Springdale, AR by specialty
• Community/Retail Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; 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.