Ronald Edgar Norris, P.D. – Pharmacist

Key facts

NPI: 1104813674
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: 6095 (AR)
Practice address: 712 Holly St
MC Gehee, AR 71654-2111
Phone: (870) 222-3080
Fax: (870) 222-6561
NPI assigned: Sep 30, 2005
Sex: Male
Sole proprietor: Yes

Organizations & group practices 1

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.

Holly Street Drugs Inc Community/Retail Pharmacy · MC Gehee, AR · NPI 1942296603

NPD (past) Authorized official

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
6095	AR	MD	Pharmacist

Practice roles

Organization	Specialty	Status	New patients
Holly Street Drugs Inc		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	6095	AR	Yes

Addresses

Primary practice location

712 Holly St
MC Gehee, AR 71654-2111

Mailing address

712 Holly St
MC Gehee, AR 71654-2111
Phone (870) 222-3080

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 12, 2007.

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1104813674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 HOLLY ST",
            "city": "MC GEHEE",
            "state": "AR",
            "postal_code": "716542111",
            "telephone_number": "870-222-3080",
            "fax_number": "870-222-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 HOLLY ST",
            "city": "MC GEHEE",
            "state": "AR",
            "postal_code": "716542111",
            "telephone_number": "870-222-3080",
            "fax_number": "870-222-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "RONALD",
        "middle_name": "EDGAR",
        "credential": "P.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "6095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Gehee, AR

All providers in MC Gehee, AR · Pharmacist in Arkansas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.