Active NPI
William Clay Canada Jr., R PH
- Pharmacist
- Dumas, AR
National Provider Identifier
1083608376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0402470
- Practice address
- 101 W Waterman St
Dumas, AR 71639-2139 - Phone
- (870) 382-4343
- NPI assigned
- Sep 1, 2005
- Last updated
- Jun 20, 2008
- Sex
- Male
- 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 | 0402470 | AR | Primary |
Addresses
Primary practice location
101 W Waterman St
Dumas, AR 71639-2139
Mailing address
101 W Waterman St
Dumas, AR 71639-2139
Phone (870) 382-4343
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0402470 | AR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Canada, Inc. | Past | Accepting new patients |
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": "1125532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213920000000",
"number": "1083608376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 W WATERMAN ST",
"city": "DUMAS",
"state": "AR",
"postal_code": "716392139",
"telephone_number": "870-382-4343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W WATERMAN ST",
"city": "DUMAS",
"state": "AR",
"postal_code": "716392139",
"telephone_number": "870-382-4343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANADA",
"first_name": "WILLIAM",
"middle_name": "CLAY",
"name_suffix": "Jr.",
"credential": "R PH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-01",
"last_updated": "2008-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "0402470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dumas, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.