Organization Active NPI

Bryant Holifield & Davis Pharmacy

Doing business as Norman and Baker Pharmacy

  • Community/Retail Pharmacy
  • Newport, AR
National Provider Identifier
1043290299
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
AR-20190 Issued in AR
Legal business name
BRYANT HOLIFIELD & DAVIS PHARMACY
Doing business as
Norman and Baker Pharmacy
Practice address
2200 Malcolm Avenue Suite D
Newport, AR 72112
Phone
(870) 523-9472
Fax
(870) 523-9364
NPI assigned
Jan 21, 2006
Last updated
May 9, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2019

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

Authorized official

Name
Miss Mary Kathryn Davis, PHARMDNPI 1336738251
Title
Officer/Secretary
Phone
(870) 523-9472

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 AR 20190 AR
Community/Retail Pharmacy 3336C0003X AR-20190 AR Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

2200 Malcolm Avenue Suite D
Newport, AR 72112

Mailing address

2200 Malcolm Avenue Suite D
Newport, AR 72112
Phone (870) 523-9472

Other names 1

  • Norman and Baker Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180430002039 AR Part B Supplier - Mass Immunization (Roster Biller Only) 3577827450 Practice locations: Newport, AR

National Provider Directory

National Provider Directory
Tax ID family
Bryant Holifield Davis 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.

Locations

2200 Malcolm Ave
Ste D
Newport, AR 72112
Phone (870) 523-9472

Practitioners & affiliated clinicians

Practitioners 2

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": "1137801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557360000000",
    "number": "1043290299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 MALCOLM AVENUE SUITE D",
            "city": "NEWPORT",
            "state": "AR",
            "postal_code": "72112",
            "telephone_number": "870-523-9472",
            "fax_number": "870-523-9364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 MALCOLM AVENUE SUITE D",
            "city": "NEWPORT",
            "state": "AR",
            "postal_code": "72112",
            "telephone_number": "870-523-9472",
            "fax_number": "870-523-9364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYANT HOLIFIELD & DAVIS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-21",
        "last_updated": "2019-05-09",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "KATHRYN",
        "authorized_official_title_or_position": "OFFICER/SECRETARY",
        "authorized_official_telephone_number": "870-523-9472",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AR",
            "license": "AR 20190",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR-20190",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Norman and Baker Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Norman and Baker Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newport, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.