Pruett'S Food, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PRUETT'S FOOD, INC.

Practice address

101 W. Main
Lockesburg, AR 71846

Phone

(870) 289-2085

Fax

(870) 289-2088

NPI assigned

Nov 8, 2019

Organization subpart

Yes

Parent organization

PRUETT'S FOOD, INC.As reported in NPPES

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

Authorized official

Name

Shannon Pruett

Title

Pharmacy Director

Phone

(870) 289-2085

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pruett's Discount Pharmacy Doing business as

Electronic endpoints 1

Part of

Pruetts Food Inc

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

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739404800000",
    "number": "1104461532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 MAIN ST",
            "city": "BROKEN BOW",
            "state": "OK",
            "postal_code": "747283976",
            "telephone_number": "870-289-2085",
            "fax_number": "580-584-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W. MAIN",
            "city": "LOCKESBURG",
            "state": "AR",
            "postal_code": "71846",
            "telephone_number": "870-289-2085",
            "fax_number": "870-289-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUETT'S FOOD, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRUETT'S FOOD, INC.",
        "enumeration_date": "2019-11-08",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A",
        "authorized_official_last_name": "PRUETT",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "870-289-2085"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "238810407",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Lockesburg",
            "affiliation": "Y",
            "affiliationName": "PRUETTS FOOD INC",
            "address_1": "201 S Park Dr",
            "city": "Broken Bow",
            "state": "OK",
            "country_code": "US",
            "postal_code": "747284737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Pruett's Discount Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pruett's Discount Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Cassandra Lynne Schroer, NP

• All providers in Lockesburg, AR
• Community/Retail Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.