Teasley Drug Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

AR13411 Issued in AR

Legal business name

TEASLEY DRUG INC

Doing business as

Teasley Drug

Practice address

205 Atlanta St SE
Gravette, AR 72736-9364

Phone

(479) 787-5966

Fax

(479) 787-5393

NPI assigned

Aug 31, 2006

Last updated

Feb 28, 2017By 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

Lindsey Watford, PHARMDNPI 1235754409

Title

Owner/Pharmacist

Phone

(479) 787-5966

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• TEASLEY DRUG Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 2

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.

• Lindsey S Watford, PHARMD

  • Pharmacist
  • Gravette, AR
  • NPI 1235754409
  NPD Authorized official
• Colton Moorman

  • Pharmacist
  • Gravette, AR
  • NPI 1831791730
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488240000000",
    "number": "1275645269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 120",
            "city": "GRAVETTE",
            "state": "AR",
            "postal_code": "727360120",
            "telephone_number": "479-787-5966",
            "fax_number": "479-787-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 ATLANTA ST SE",
            "city": "GRAVETTE",
            "state": "AR",
            "postal_code": "727369364",
            "telephone_number": "479-787-5966",
            "fax_number": "479-787-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEASLEY DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2017-02-28",
        "status": "A",
        "authorized_official_last_name": "WATFORD",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "479-787-5966",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR13411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "602301509",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100244910A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1994355",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176183407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TEASLEY DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sgoh Acquisition Inc (Ozarks Community Hospital of Gravette)
• Sgoh Acquisition Inc (Ozarks Community Hospital of Gravette)
• Marva Shockley
• Lloyd Layton Spencer, M.D.
• Kenneth C. Stewart, D.O.
• Donald Tribbey, D.O.
• David John Tucker, MD
• Uplift, LLC
• Molly Claire Vaughan, LMSW
• Wal-Mart Stores Inc (Wal-Mart Pharmacy 10-3033)

• Community/Retail Pharmacy in Gravette, AR
• Providers in Gravette, AR by specialty
• Community/Retail Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; 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.