Organization Active NPI

Mountain Home Christian Clinic, Inc

  • Clinic Pharmacy
  • Mountain Home, AR
National Provider Identifier
1134097199
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
Legal business name
MOUNTAIN HOME CHRISTIAN CLINIC, INC
Practice address
421 W Wade Ave
Mountain Home, AR 72653-4622
Phone
(870) 425-5010
Fax
(870) 425-5010
NPI assigned
Oct 29, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Authorized official

Name
Randall Fragoules, RPH
Title
Pharmacist in Charge
Phone
(870) 425-5010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X Primary

Addresses

Primary practice location

421 W Wade Ave
Mountain Home, AR 72653-4622

Mailing address

421 W Wade Ave
Mountain Home, AR 72653-4622
Phone (870) 425-5010

National Provider Directory

National Provider Directory

Locations

421 W Wade Ave
Mountain Home, AR 72653
Phone (870) 424-5010

NPI Registry JSON

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

{
    "created_epoch": "1761696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1134097199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 W WADE AVE",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726534622",
            "telephone_number": "870-425-5010",
            "fax_number": "870-425-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 W WADE AVE",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726534622",
            "telephone_number": "870-425-5010",
            "fax_number": "870-425-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN HOME CHRISTIAN CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-29",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "FRAGOULES",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "870-425-5010",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.