NPIMap

Organization Active NPI

McCoy-Tygart Drug Store Inc

Doing business as McCoy Tygart Drug

  • Community/Retail Pharmacy
  • Sheridan, AR
National Provider Identifier
1073579843
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
AR06048 Issued in AR
Legal business name
MCCOY-TYGART DRUG STORE INC
Doing business as
McCoy Tygart Drug
Practice address
821 N Rock St
Sheridan, AR 72150-7623
Phone
(870) 942-5121
Fax
(870) 942-2592
NPI assigned
Apr 21, 2006
Last updated
Dec 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Authorized official

Name
Mr. Phillip A Tygart, P.D.NPI 1932318664
Title
Pharmacist,Corp.Ofcer.
Phone
(870) 942-5121

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
Durable Medical Equipment & Medical Supplies 332B00000X AR06048 AR
Community/Retail Pharmacy 3336C0003X AR06048 AR Primary

Addresses

Primary practice location

821 N Rock St
Sheridan, AR 72150-7623

Mailing address

PO Box 217
Sheridan, AR 72150-0217
Phone (870) 942-5121

Other identifiers 2

IdentifierTypeStateIssuer
100377407MedicaidAR
102512716MedicaidAR

Other names 1

  • McCoy Tygart Drug Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20100930079320 AR DME Supplier - Pharmacy 5193844561 Practice locations: Sheridan, AR
O20160824000830 AR Part B Supplier - Mass Immunization (Roster Biller Only) 5193844561 Practice locations: Sheridan, AR
O20230912001143 AR Part B Supplier - Pharmacy 5193844561 Practice locations: Sheridan, AR

National Provider Directory

National Provider Directory
Tax ID family
McCoy Tygart Drug2 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

815 N Rock St
Sheridan, AR 72150
Phone (870) 942-5121

821 N Rock St
Sheridan, AR 72150
Phone (870) 942-5121

Practitioners & affiliated clinicians

Practitioners 9

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": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1073579843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 217",
            "city": "SHERIDAN",
            "state": "AR",
            "postal_code": "721500217",
            "telephone_number": "870-942-5121",
            "fax_number": "870-942-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 N ROCK ST",
            "city": "SHERIDAN",
            "state": "AR",
            "postal_code": "721507623",
            "telephone_number": "870-942-5121",
            "fax_number": "870-942-2592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCOY-TYGART DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A",
        "authorized_official_last_name": "TYGART",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHARMACIST,CORP.OFCER.",
        "authorized_official_telephone_number": "870-942-5121",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AR",
            "license": "AR06048",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR06048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100377407",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102512716",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McCoy Tygart Drug",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "McCoy Tygart Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sheridan, AR

Sources for this page

Verify at the official NPI Registry.