Hancock Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

AR20386 Issued in AR

Legal business name

HANCOCK PHARMACY INC

Doing business as

Walden Drug

Practice address

3104 W Kingshighway
Paragould, AR 72450-2612

Phone

(870) 236-6118

Fax

(870) 236-5886

NPI assigned

Oct 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jeremy Hancock, PHARMDNPI 1205557832

Title

Pic

Phone

(870) 236-6118

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• WALDEN DRUG Doing business as

Medicare fee-for-service enrollment

Enrolled in AR2 enrollments

Enrollment records 2

Tax ID family

Hancock 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.

• Hancock Pharmacy Inc

  dba Walden Drug

  • Long Term Care Pharmacy
  • Paragould, AR
  • NPI 1780451351
  NPD tax ID

Locations

Practitioners 2

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

• Jeremy Hancock, PHARMD

  • Pharmacist
  • Paragould, AR
  • NPI 1205557832
  NPD Authorized official
• Natalie Denise Underwood, PHARM D

  • Pharmacist
  • Paragould, AR
  • NPI 1689399040
  NPD

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566432000000",
    "number": "1073601571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 W KINGSHIGHWAY",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724502612",
            "telephone_number": "870-236-6118",
            "fax_number": "870-236-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 W KINGSHIGHWAY",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724502612",
            "telephone_number": "870-236-6118",
            "fax_number": "870-236-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANCOCK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2019-08-22",
        "status": "A",
        "authorized_official_last_name": "HANCOCK",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "870-236-6118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR20386",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "603176306",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1994135",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155534407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALDEN DRUG",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WALDEN DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan Suzanne Hamilton
• Rhonda Hamilton
• Butch Edward Hamlett, D.D.S.
• Loreal Hamlett
• Brooke Hampton
• Hancock Pharmacy Inc (Walden Drug)
• Jeremy Hancock, PHARMD
• Sierra Hancock
• Hands on Learning, LLC.
• Brianna Kay Hanes

• Community/Retail Pharmacy in Paragould, AR
• Providers in Paragould, 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 Aug 22, 2019; 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.