NPIMap

Organization Active NPI

Town & Country Grocers of Fredericktown Mo Inc

  • Community/Retail Pharmacy
  • Trumann, AR
National Provider Identifier
1205902962
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
AR20262 Issued in AR
Legal business name
TOWN & COUNTRY GROCERS OF FREDERICKTOWN MO INC
Doing business as
PRICE CHOPPER PHARMACY
Practice address
801 Highway 463 N
Trumann, AR 72472-1636
Phone
(870) 483-8015
Fax
(870) 483-7528
NPI assigned
Nov 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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

Authorized official

Name
Bobbie Hufford
Title
Ceo
Phone
(573) 783-5703

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X AR20262 AR Primary

Addresses

Primary practice location

801 Highway 463 N
Trumann, AR 72472-1636

Mailing address

801 Highway 463 N
Trumann, AR 72472-1636
Phone (870) 483-8015

Other identifiers 2

IdentifierTypeStateIssuer
142058407MedicaidAR
1988319OtherPK

Other names 1

  • PRICE CHOPPER PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Country Mart Pharmacy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

801 Highway 463 N
Trumann, AR 72472
Phone (870) 483-8015

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492041600000",
    "number": "1205902962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 HIGHWAY 463 N",
            "city": "TRUMANN",
            "state": "AR",
            "postal_code": "724721636",
            "telephone_number": "870-483-8015",
            "fax_number": "870-483-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 HIGHWAY 463 N",
            "city": "TRUMANN",
            "state": "AR",
            "postal_code": "724721636",
            "telephone_number": "870-483-8015",
            "fax_number": "870-483-7528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN & COUNTRY GROCERS OF FREDERICKTOWN MO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2017-04-13",
        "status": "A",
        "authorized_official_last_name": "HUFFORD",
        "authorized_official_first_name": "BOBBIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-783-5703"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR20262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142058407",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1988319",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRICE CHOPPER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Trumann, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; 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.