NPIMap

Organization Active NPI

Access Pharmacy

Doing business as pediatric nutrition providers of arkansas

  • Community/Retail Pharmacy
  • Benton, AR
National Provider Identifier
1144301136
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
AR20528 Issued in AR
Legal business name
ACCESS PHARMACY
Doing business as
pediatric nutrition providers of arkansas
Practice address
920 Edison Ave
Suite 9
Benton, AR 72015-4502
Phone
(501) 315-2025
Fax
(501) 315-1034
NPI assigned
Oct 18, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Leonard R Gray, PHARMD
Title
Owner
Phone
(501) 315-2025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X AR20528 AR Primary

Addresses

Primary practice location

920 Edison Ave
Suite 9
Benton, AR 72015-4502

Mailing address

920 Edison Ave
Suite 9
Benton, AR 72015-4502
Phone (501) 315-2025

Other names 1

  • pediatric nutrition providers of arkansas Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Access Pharmacy5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

920 Edison Ave
Ste 9
Benton, AR 72015
Phone (501) 315-7337

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144301136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 EDISON AVE",
            "address_2": "SUITE 9",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720154502",
            "telephone_number": "501-315-2025",
            "fax_number": "501-315-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 EDISON AVE",
            "address_2": "SUITE 9",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720154502",
            "telephone_number": "501-315-2025",
            "fax_number": "501-315-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-315-2025",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR20528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "pediatric nutrition providers of arkansas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Benton, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.