Kelly Elizabeth McNinch, RPH
Individual provider Active NPI Pharmacist · Vilonia, AR
NPI 1164028320 · NPPES record last updated Dec 11, 2020
Key facts
- NPI
- 1164028320
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PD07721 (AR)
- Practice address
- 1086 Main St
Vilonia, AR 72173-8003 - Phone
- (501) 796-0150
- Fax
- (501) 796-0134
- NPI assigned
- Dec 11, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PD07721 | AR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harps Food Stores, Inc | Current |
Accepting new patients | |
| Harps Food Stores, Inc | Past |
Accepting new patients |
Locations
1086 Main St
Vilonia, AR 72173
Phone (501) 796-0150
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PD07721 | AR | Yes |
Addresses
Primary practice location
1086 Main St
Vilonia, AR 72173-8003
Mailing address
256 Cardin Cir
Enola, AR 72047-8223
Phone (501) 454-3020
Other providers in Vilonia, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2020. 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.