NPIMap

Organization Active NPI

G and M Pharmacy Inc

  • Community/Retail Pharmacy
  • Jonesboro, AR
National Provider Identifier
1285706069
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
0417205 Issued in AR
Legal business name
G AND M PHARMACY INC
Practice address
325 Southwest Dr
Suite a
Jonesboro, AR 72401-5854
Phone
(870) 935-1340
Fax
(870) 935-3329
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Authorized official

Name
Preston Jett Jones, PHARMDNPI 1184063406
Title
Pharmacist in Charge
Phone
(870) 935-1340

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 0417205 AR Primary

Addresses

Primary practice location

325 Southwest Dr
Suite a
Jonesboro, AR 72401-5854

Mailing address

325 Southwest Dr
Suite a
Jonesboro, AR 72401-5854
Phone (870) 935-1340

Other identifiers 2

IdentifierTypeStateIssuer
0417205OtherOTHER ID NUMBER-COMMERCIAL NUMBER
100869407MedicaidAR

Other names 1

  • The Medicine Shoppe Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20091021000059 AR Part B Supplier - Mass Immunization (Roster Biller Only) 6507903713 Practice locations: Jonesboro, AR
O20100930018046 AR DME Supplier - Pharmacy 6507903713 Practice locations: Jonesboro, AR

National Provider Directory

National Provider Directory
Tax ID family
G and M Pharmacy Inc2 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.

Locations

325 Southwest Dr
#A
Jonesboro, AR 72401
Phone (870) 935-1340

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680566400000",
    "number": "1285706069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 SOUTHWEST DR",
            "address_2": "SUITE A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015854",
            "telephone_number": "870-935-1340",
            "fax_number": "870-935-3328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 SOUTHWEST DR",
            "address_2": "SUITE A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015854",
            "telephone_number": "870-935-1340",
            "fax_number": "870-935-3329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G AND M PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "PRESTON",
        "authorized_official_middle_name": "JETT",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "870-935-1340",
        "authorized_official_credential": "PHARMD"
    },
    "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": "0417205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0417205",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100869407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medicine Shoppe",
            "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 Apr 4, 2023; 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.