NPIMap

Organization Active NPI

Marvell Clinic Pharmacy, Inc.

  • Pharmacy
  • Marvel, AR
National Provider Identifier
1295752376
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
AR20373 Issued in AR
Legal business name
MARVELL CLINIC PHARMACY, INC.
Practice address
406 S Mill St
Marvel, AR 72366-0217
Phone
(870) 829-1044
Fax
(870) 829-1067
NPI assigned
Jul 16, 2006
Last updated
Feb 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Authorized official

Name
Mr. John William Gray, PHARMACIST
Title
Owner Pharm
Phone
(870) 829-1044

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X AR20373 AR
Pharmacy 333600000X AR20373 AR Primary

Addresses

Primary practice location

406 S Mill St
Marvel, AR 72366-0217

Mailing address

PO Box 217
406 S. Mill St
Marvell, AR 72366-0217
Phone (870) 829-1044

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1295752376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 217",
            "address_2": "406 S. MILL ST",
            "city": "MARVELL",
            "state": "AR",
            "postal_code": "723660217",
            "telephone_number": "870-829-1044",
            "fax_number": "870-829-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 S MILL ST",
            "city": "MARVEL",
            "state": "AR",
            "postal_code": "723660217",
            "telephone_number": "870-829-1044",
            "fax_number": "870-829-1067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARVELL CLINIC PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER PHARM",
        "authorized_official_telephone_number": "870-829-1044",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AR",
            "license": "AR20373",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AR",
            "license": "AR20373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.