NPIMap

Organization Active NPI

West Side Pharmacy Inc.

  • Long Term Care Pharmacy
  • Benton, AR
National Provider Identifier
1144870957
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
WEST SIDE PHARMACY INC.
Practice address
620 W South St
Benton, AR 72015-4258
Phone
(501) 778-3151
Fax
(501) 778-7329
NPI assigned
Sep 13, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Authorized official

Name
Charles Blake Torres
Title
Pharmacist/Manager
Phone
(501) 778-3151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

620 W South St
Benton, AR 72015-4258

Mailing address

620 W South St
Benton, AR 72015-4258
Phone (501) 778-3151

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1144870957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W SOUTH ST",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720154258",
            "telephone_number": "501-778-3151",
            "fax_number": "501-778-7329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W SOUTH ST",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720154258",
            "telephone_number": "501-778-3151",
            "fax_number": "501-778-7329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST SIDE PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-13",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "PHARMACIST/MANAGER",
        "authorized_official_telephone_number": "501-778-3151"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 19, 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.