NPIMap

Organization Active NPI

Soo's Health Mart

Doing business as Soo's Drug

  • Durable Medical Equipment & Medical Supplies
  • Jonesboro, AR
National Provider Identifier
1225158777
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
AR20121 Issued in AR
Legal business name
SOO'S HEALTH MART
Doing business as
Soo's Drug
Practice address
2905 E Nettleton Ave
Jonesboro, AR 72401-4534
Phone
(870) 932-6930
Fax
(870) 932-1378
NPI assigned
Mar 29, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Krystal Soo, P.D.NPI 1366596124
Title
Owner
Phone
(870) 932-6930

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
Durable Medical Equipment & Medical Supplies 332B00000X AR20121 AR Primary

Addresses

Primary practice location

2905 E Nettleton Ave
Jonesboro, AR 72401-4534

Mailing address

2905 E Nettleton Ave
Jonesboro, AR 72401-4534
Phone (870) 932-6930

Other names 1

  • Soo's Drug Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225158777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 E NETTLETON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014534",
            "telephone_number": "870-932-6930",
            "fax_number": "870-932-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 E NETTLETON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014534",
            "telephone_number": "870-932-6930",
            "fax_number": "870-932-1378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOO'S HEALTH MART",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOO",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-932-6930",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "P.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AR",
            "license": "AR20121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Soo's Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.