Maumelle Family Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MAUMELLE FAMILY PHARMACY LLC

Practice address

1701 Club Manor Dr
Maumelle, AR 72113-7401

Phone

(501) 851-4949

Fax

(501) 851-7390

NPI assigned

Jul 19, 2023

Organization subpart

No

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

Authorized official

Name

Randy Kassissieh, PHARMD

Title

Owner

Phone

(501) 851-4949

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Tax ID family

Maumelle Family Pharmacy LLC2 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.

• Maumelle Family Pharmacy LLC

  • Long Term Care Pharmacy
  • Maumelle, AR
  • NPI 1023798600
  NPD tax ID

Locations

Practitioners 1

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

• Kara Foreman, PHARMD

  • Pharmacist
  • Maumelle, AR
  • NPI 1871996231
  NPD (past)

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698796800000",
    "number": "1043990625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 CLUB MANOR DR",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721137401",
            "telephone_number": "501-851-4949",
            "fax_number": "501-851-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 CLUB MANOR DR",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721137401",
            "telephone_number": "501-851-4949",
            "fax_number": "501-851-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAUMELLE FAMILY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A",
        "authorized_official_last_name": "KASSISSIEH",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-851-4949",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maumelle Family Dental Care
• Maumelle Family Dentistry
• Maumelle Family Dentistry, PLLC
• Maumelle Family Medicine, LLC
• Maumelle Family Pharmacy LLC
• Maumelle Health Services, LLC
• Maumelle Investments & Associates, LLC
• Maumelle Medical Clinic
• Maumelle Sleep Solutions, LLC
• Elizabeth McGhee, MS, ATC, CSCS

• Community/Retail Pharmacy in Maumelle, AR
• Providers in Maumelle, 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 Nov 1, 2023; 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.