West Side Pharmacy- Military Road LLC

Primary specialty

PharmacyTaxonomy code 333600000X

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

Last updated

Feb 14, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Maddison Schuller, PHARMDNPI 1104499201

Title

Owner

Phone

(501) 778-3151

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Tax ID family

West Side Pharmacy- Military Road LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• West Side Pharmacy- Military Road LLC

  • Long Term Care Pharmacy
  • Benton, AR
  • NPI 1861297897
  NPD tax ID

Locations

Practitioners 6

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.

• Maddison Elaine Schuller, PHARMD

  • Pharmacist
  • Benton, AR
  • NPI 1104499201
  Authorized official Same address or phone
• Michael David Butler, PHARM D

  • Pharmacist
  • Hot Springs Village, AR
  • NPI 1710083738
  NPD
• James Zackary Haley, PHARMD

  • Pharmacist
  • Benton, AR
  • NPI 1912506056
  NPD
• Dylan Jones, PHARM.D.

  • Pharmacist
  • Fayetteville, AR
  • NPI 1144603887
  NPD
• Jennifer Idalia Portillo

  • Pharmacist
  • Benton, AR
  • NPI 1750271920
  NPD
• Isabelle Diane Reaves, PHARMD

  • Pharmacist
  • Benton, AR
  • NPI 1154041689
  NPD (past)

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": []
}

• Wellness Mental Health Services Inc
• Courtney Wells, RECOVERY ASSISTANT
• West Side Compounding LLC
• West Side Pharmacy Inc.
• West Side Pharmacy Incorporated (West Side Pharmacy)
• West Side Pharmacy- Military Road LLC
• West Side Pharmacy, Inc. (West Side Clinical Services)
• West Side Pharmacy, Inc. (West Side Pharmacy)
• Christina Hyde West, MA CCC SLP
• Wendy M West, APN

• Pharmacy in Benton, AR
• Providers in Benton, AR by specialty
• Pharmacy in Arkansas

• 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.

Verify at the official NPI Registry.