Clarksville Family Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

AR20656 Issued in AR

Legal business name

CLARKSVILLE FAMILY PHARMACY INC

Doing business as

Clarksville Family Pharmacy

Practice address

510 S Rogers St Ste 3
Clarksville, AR 72830-3792

Phone

(479) 647-3138

Fax

(479) 647-3144

NPI assigned

Jun 15, 2011

Organization subpart

No

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

Authorized official

Name

Ward Lee, P.D.

Title

President

Phone

(479) 774-5921

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Clarksville Family Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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

• Charles Edward Lee, P.D.

  • Pharmacist
  • Clarksville, AR
  • NPI 1700482676
  NPD
• Zachary Taylor, PHARMD

  • Pharmacist
  • Clarksville, AR
  • NPI 1407452980
  NPD (past)
• Amelia Rose Whitkanack, PHARMD

  • Pharmacist
  • Dardanelle, AR
  • NPI 1922609197
  NPD (past)

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481846400000",
    "number": "1194010421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 S ROGERS ST STE 3",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728303792",
            "telephone_number": "479-647-3138",
            "fax_number": "479-647-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S ROGERS ST STE 3",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728303792",
            "telephone_number": "479-647-3138",
            "fax_number": "479-647-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSVILLE FAMILY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-15",
        "last_updated": "2016-12-16",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "WARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-774-5921",
        "authorized_official_credential": "P.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR20656",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2129945",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187120407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarksville Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Astrid Christensen
• John Clarady
• Erin Elizabeth Ann Clark, LAC
• Clarksville Community Health & Rehabilitation LLC
• Clarksville Dentistry, Inc.
• Clarksville Health & Rehab,LLC
• Clarksville Medical Group, P.a.
• Clarksville Medical Group, P.a.
• Clarksville Medical Group, P.a.
• Clarksville Nursing and Rehab, LLC

• Community/Retail Pharmacy in Clarksville, AR
• Providers in Clarksville, AR by specialty
• Community/Retail Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.