Active NPI
Phyllis Cleland Wilcox, PD
- Pharmacist
- Waldron, AR
National Provider Identifier
1063008944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD06835
- Practice address
- 1350 W 6TH St
Waldron, AR 72958-2600 - Phone
- (479) 637-1007
- Fax
- (479) 637-1009
- NPI assigned
- Dec 15, 2020
- Last updated
- Dec 15, 2020
- 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 | PD06835 | AR | Primary |
Addresses
Primary practice location
1350 W 6TH St
Waldron, AR 72958-2600
Mailing address
2769 W Highway 28
Waldron, AR 72958-7318
Phone (479) 207-3312
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 |
|---|---|---|---|
| PD06835 | AR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harps Food Stores, Inc | Current | Accepting new patients |
Locations
1350 W 6th St
Waldron, AR 72958
Phone (479) 637-1007
Organizations & group practices 1
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": "1607990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607990400000",
"number": "1063008944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2769 W HIGHWAY 28",
"city": "WALDRON",
"state": "AR",
"postal_code": "729587318",
"telephone_number": "479-207-3312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 W 6TH ST",
"city": "WALDRON",
"state": "AR",
"postal_code": "729582600",
"telephone_number": "479-637-1007",
"fax_number": "479-637-1009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILCOX",
"first_name": "PHYLLIS",
"middle_name": "CLELAND",
"name_prefix": "Mrs.",
"credential": "PD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-15",
"last_updated": "2020-12-15",
"certification_date": "2020-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD06835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waldron, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.