Wilson Bearden Pharmacy Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

WILSON BEARDEN PHARMACY INC

Doing business as

Wilson Bearden pharmacy

Practice address

134 N Washington
Magnolia, AR 71753-2856

Phone

(870) 234-1062

Fax

(870) 234-8366

NPI assigned

Feb 15, 2024

Organization subpart

No

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

Authorized official

Name

Ivy D Moore, PDNPI 1194943225

Title

Owner

Phone

(870) 234-1062

Specialties & licenses 1

Addresses

Other names 1

• Wilson Bearden pharmacy Doing business as

Practitioners 1

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

• Ivy D Moore, PD

  • Pharmacist
  • Magnolia, AR
  • NPI 1194943225
  NPD Authorized official

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1093570368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 N WASHINGTON",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532856",
            "telephone_number": "870-234-1062",
            "fax_number": "870-234-8366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 N WASHINGTON",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532856",
            "telephone_number": "870-234-1062",
            "fax_number": "870-234-8366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON BEARDEN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "IVY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-234-1062",
        "authorized_official_credential": "PD"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilson Bearden pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Rebecca Williamson, M.S., CCC-SLP
• Cecelia Willis
• Christopher M Willis, PTA
• Jamie Willis
• Latrina Willis, LPC
• Wilson Bearden Pharmacy Inc
• Terries Wilson
• Shuron Witcher
• Corban Wood
• Dylan Wood

• Long Term Care Pharmacy in Magnolia, AR
• Providers in Magnolia, AR by specialty
• Long Term Care Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.