Jeffrey Dale Prince, PD

Primary specialty

PharmacistTaxonomy code 183500000X

License

AR07513 Issued in AR

Practice address

211 East Stadium Drive
Magnolia, AR 71753-2032

Phone

(870) 234-7292

Fax

(870) 234-4443

NPI assigned

Sep 27, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• College Pharmacy Inc

  • Community/Retail Pharmacy
  • Magnolia, AR
  • NPI 1023099660
  NPD Authorized official
• College Pharmacy Inc

  • Long Term Care Pharmacy
  • Magnolia, AR
  • NPI 1609572551
  NPD

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1093439739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 EAST STADIUM DRIVE",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532032",
            "telephone_number": "870-234-7292",
            "fax_number": "870-234-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 EAST STADIUM DRIVE",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532032",
            "telephone_number": "870-234-7292",
            "fax_number": "870-234-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "JEFFREY",
        "middle_name": "DALE",
        "name_prefix": "Mr.",
        "credential": "PD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "AR07513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Deann Pickett, COTA
• Wendi Michelle Pittman
• Kennedy Powell
• Madison Jewel Powell, APRN
• Shawntel Marie Price, APRN
• Professional Counseling Services of Magnolia
• Haley M Quintana
• Ricodaro Rainey
• Mercedes Ray, LCSW
• Jennifer Rayburn, MHPP

• Pharmacist in Magnolia, AR
• Providers in Magnolia, AR by specialty
• Pharmacist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; 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.