Organization Active NPI

T&J Ventures LLC

  • Community/Retail Pharmacy
  • Berryville, AR
National Provider Identifier
1194182485
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
AR01783 Issued in AR
Legal business name
T&J VENTURES LLC
Practice address
408 Public SQ
Berryville, AR 72616-3958
Phone
(870) 423-2737
Fax
(870) 423-7253
NPI assigned
Jan 19, 2016
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
Tara WillmottNPI 1477974335
Title
Owner, Ao
Phone
(870) 365-6777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X AR01783 AR Primary

Addresses

Primary practice location

408 Public SQ
Berryville, AR 72616-3958

Mailing address

408 Public SQ
Berryville, AR 72616-3958
Phone (870) 423-2737

Other identifiers 2

IdentifierTypeStateIssuer
212641407MedicaidAR
2157489OtherPK

Other names 1

  • Poynor Drug Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170112000451 AR Part B Supplier - Mass Immunization (Roster Biller Only) 8325329014 Practice locations: Berryville, AR

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2327215Poynor Drug408 Public Square, Berryville, AR 72616Certificate of waiverJul 17, 2027

National Provider Directory

National Provider Directory

Locations

408 Public Sq
Berryville, AR 72616
Phone (870) 423-2737

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1194182485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 PUBLIC SQ",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726163958",
            "telephone_number": "870-423-2737",
            "fax_number": "870-423-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 PUBLIC SQ",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726163958",
            "telephone_number": "870-423-2737",
            "fax_number": "870-423-7253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T&J VENTURES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-19",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "WILLMOTT",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "OWNER,  AO",
        "authorized_official_telephone_number": "870-365-6777"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR01783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212641407",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2157489",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Poynor Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berryville, 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.
  • 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.