Douglas Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

Y004878 Issued in AZ

Legal business name

DOUGLAS PHARMACY LLC

Practice address

94 W 5TH St
Douglas, AZ 85607-2851

Phone

(520) 364-2315

Fax

(520) 364-2318

NPI assigned

Aug 5, 2007

Organization subpart

No

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

Authorized official

Name

Greg Shumaker

Title

Owner

Phone

(520) 364-2315

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• DOUGLAS HEALTH MART PHARMACY Doing business as

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314576000000",
    "number": "1083805261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 597",
            "city": "SAINT DAVID",
            "state": "AZ",
            "postal_code": "856300597",
            "telephone_number": "520-240-3936",
            "fax_number": "520-720-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 W 5TH ST",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856072851",
            "telephone_number": "520-364-2315",
            "fax_number": "520-364-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2011-08-29",
        "status": "A",
        "authorized_official_last_name": "SHUMAKER",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-364-2315"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y004878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0354895",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290702",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOUGLAS HEALTH MART PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Douglas Arc
• Douglas Community Hospital
• Douglas Community Hospital, Inc.
• Douglas Dental, LLC
• Douglas Family Care PLLC
• Douglas Pharmacy, LLC
• Douglas Primary Eye Care PC
• Douglas Unified School District
• Douglas Unified School District
• Douglas Unified School District #27

• Community/Retail Pharmacy in Douglas, AZ
• Providers in Douglas, AZ by specialty
• Community/Retail Pharmacy in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; 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.