Active NPI
Austin Gilbreath
- Long Term Care Pharmacy
- Ash Flat, AR
National Provider Identifier
1104484971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- License
- AR01531
- Practice address
- 970D Ash Flat Dr
Ash Flat, AR 72513-9533 - Phone
- (870) 994-7377
- Fax
- (870) 994-7399
- NPI assigned
- Jun 5, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | AR01531 | AR | Primary |
Addresses
Primary practice location
970D Ash Flat Dr
Ash Flat, AR 72513-9533
Mailing address
PO Box 278
Ash Flat, AR 72513-0278
Phone (870) 994-7377
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100176407 | Medicaid | AR |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AR01531 | AR | MD | Long Term Care Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ash Flat Pharmacy, Inc. | Long Term Care Pharmacy | Current | Accepting new patients |
| Ash Flat Pharmacy, Inc. | Current | Accepting new patients |
Locations
970 Ash Flat Dr
#D
Ash Flat, AR 72513
Phone (870) 994-7377
Organizations & group practices 2
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.
-
- Pharmacist
- Ash Flat, AR
- NPI 1184625808
-
- Long Term Care Pharmacy
- Ash Flat, AR
- NPI 1265091433
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559692800000",
"number": "1104484971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 278",
"city": "ASH FLAT",
"state": "AR",
"postal_code": "725130278",
"telephone_number": "870-994-7377",
"fax_number": "870-994-7399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "970D ASH FLAT DR",
"city": "ASH FLAT",
"state": "AR",
"postal_code": "725139533",
"telephone_number": "870-994-7377",
"fax_number": "870-994-7399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILBREATH",
"first_name": "AUSTIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-05",
"last_updated": "2019-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": "AR",
"license": "AR01531",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100176407",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ash Flat, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.