NPIMap

Organization Active NPI

East End Express Pharmacy Inc

Doing business as East End Express Pharmacy

  • Community/Retail Pharmacy
  • Hensley, AR
National Provider Identifier
1073014866
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
AR20875 Issued in AR
Legal business name
EAST END EXPRESS PHARMACY INC
Doing business as
East End Express Pharmacy
Practice address
21019 Highway 167, Suite 100
Hensley, AR 72065
Phone
(501) 486-4100
Fax
(501) 486-4101
NPI assigned
Feb 27, 2018
Last updated
Mar 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Authorized official

Name
Dr. Erin Brenna Greene, PHARMDNPI 1457076960
Title
Secretary/Treasurer
Phone
(501) 486-4100

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X AR20875 AR Primary

Addresses

Primary practice location

21019 Highway 167, Suite 100
Hensley, AR 72065

Mailing address

21019 Highway 167, Suite 100
Hensley, AR 72065
Phone (501) 486-4100

Other identifiers 2

IdentifierTypeStateIssuer
2176226OtherPK
225422407MedicaidAR

Other names 1

  • East End Express Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200225000284 AR Part B Supplier - Pharmacy 9234566613 Practice locations: Hensley, AR

National Provider Directory

National Provider Directory
Tax ID family
East End Express Pharmacy Inc2 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.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

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": "1519689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1073014866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21019 HIGHWAY 167, SUITE 100",
            "city": "HENSLEY",
            "state": "AR",
            "postal_code": "72065",
            "telephone_number": "501-486-4100",
            "fax_number": "501-486-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21019 HIGHWAY 167, SUITE 100",
            "city": "HENSLEY",
            "state": "AR",
            "postal_code": "72065",
            "telephone_number": "501-486-4100",
            "fax_number": "501-486-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST END EXPRESS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-27",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "BRENNA",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "501-486-4100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR20875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176226",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "225422407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East End Express Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "East End Express Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hensley, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.