Delta Drug of Dermott, Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

DELTA DRUG OF DERMOTT, INC

Practice address

111 E Peddicord St
Dermott, AR 71638-2314

Phone

(870) 538-5233

Fax

(870) 538-5717

NPI assigned

Jun 14, 2023

Organization subpart

No

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

Authorized official

Name

Calley McNemar

Title

Manager

Phone

(870) 265-2220

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Delta Drug of Dermott Doing business as

Tax ID family

Delta Drug of Dermott2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Delta Drug of Dermott, Inc

  • Community/Retail Pharmacy
  • Dermott, AR
  • NPI 1427191154
  NPD tax ID

Practitioners 1

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

• Case Henderson, PHARMD

  • Pharmacist
  • Dermott, AR
  • NPI 1770191520
  NPD

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686700800000",
    "number": "1124702592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 552",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716530552",
            "telephone_number": "870-265-2220",
            "fax_number": "870-265-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E PEDDICORD ST",
            "city": "DERMOTT",
            "state": "AR",
            "postal_code": "716382314",
            "telephone_number": "870-538-5233",
            "fax_number": "870-538-5717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA DRUG OF DERMOTT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "MCNEMAR",
        "authorized_official_first_name": "CALLEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "870-265-2220"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100262407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delta Drug of Dermott",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebekah Ayecock, PMHNP
• Bio-Medical Applications of Mississippi, Inc.
• CB King JM
• Charlie J Cruce
• Gary Dalton, DDS
• Delta Drug of Dermott, Inc
• Dermott City Nursing Home
• Dermott Day Service Center, Inc.
• Dermott Family Practice, Inc.
• Dermott High School

• Long Term Care Pharmacy in Dermott, AR
• Providers in Dermott, 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 Jun 14, 2023; 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.