Monticello Drug Company LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

MONTICELLO DRUG COMPANY LLC

Practice address

201 E Gaines St
Monticello, AR 71655-4903

Phone

(870) 367-5301

Fax

(870) 460-0257

NPI assigned

Nov 14, 2023

Organization subpart

No

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

Authorized official

Name

Khalil Crouse

Title

Owner

Phone

(870) 265-2220

Specialties & licenses 1

Addresses

Other names 1

• City Drug Doing business as

Tax ID family

Monticello Drug Company 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.

• Monticello Drug Company LLC

  • Community/Retail Pharmacy
  • Monticello, AR
  • NPI 1740371475
  NPD tax ID

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

{
    "created_epoch": "1699920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699920000000",
    "number": "1063286607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 552",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716530552",
            "telephone_number": "870-265-2220",
            "fax_number": "870-265-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E GAINES ST",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716554903",
            "telephone_number": "870-367-5301",
            "fax_number": "870-460-0257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTICELLO DRUG COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-14",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A",
        "authorized_official_last_name": "CROUSE",
        "authorized_official_first_name": "KHALIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-265-2220"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• MMC Rural Health Clinics, PLLC
• Abid Mohiuddin, MD
• Leigh Ann Montgomery
• Monticello Ambulance Service Inc.
• Monticello Dental Center PLLC
• Monticello Drug Company LLC
• Monticello Drug Inc
• Monticello Ess LLC
• Monticello Healthcare Center, LLC
• Monticello Medical Clinic PLC

• Long Term Care Pharmacy in Monticello, AR
• Providers in Monticello, AR by specialty
• Long Term Care Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.