Active NPI
West Side Pharmacy- Military Road LLC
- Pharmacy
- Benton, AR
National Provider Identifier
1245035260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- WEST SIDE PHARMACY- MILITARY ROAD LLC
- Practice address
- 1525 Military Road
Benton, AR 72015 - Phone
- (501) 778-3151
- NPI assigned
- Feb 14, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Maddison Schuller, PHARMD
- Title
- Owner
- Phone
- (501) 778-3151
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | Primary |
Addresses
Primary practice location
1525 Military Road
Benton, AR 72015
Mailing address
620 W South St
Benton, AR 72015-4258
Phone (501) 778-3151
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250806000192 | AR | Part B Supplier - Pharmacy | 3779091129 | Practice locations: Benton, AR |
National Provider Directory
National Provider Directory- Tax ID family
- West Side Pharmacy- Military Road LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Benton, AR
- NPI 1861297897
Locations
1525 Military Rd
Benton, AR 72015
Phone (501) 778-3151
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Hot Springs Village, AR
- NPI 1710083738
-
- Pharmacist
- Benton, AR
- NPI 1912506056
-
- Pharmacist
- Fayetteville, AR
- NPI 1144603887
-
- Pharmacist
- Benton, AR
- NPI 1750271920
-
- Pharmacist
- Benton, AR
- NPI 1154041689
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739491200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1739491200000",
"number": "1245035260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 W SOUTH ST",
"city": "BENTON",
"state": "AR",
"postal_code": "720154258",
"telephone_number": "501-778-3151",
"fax_number": "501-778-7329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1525 MILITARY ROAD",
"city": "BENTON",
"state": "AR",
"postal_code": "72015",
"telephone_number": "501-778-3151"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WEST SIDE PHARMACY- MILITARY ROAD LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-02-14",
"last_updated": "2025-02-14",
"certification_date": "2025-02-10",
"status": "A",
"authorized_official_last_name": "SCHULLER",
"authorized_official_first_name": "MADDISON",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "501-778-3151",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.