C & D Drug Store Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

AR05882 Issued in AR

Legal business name

C & D DRUG STORE INC

Practice address

121 N Commerce Ave
Russellville, AR 72801-3741

Phone

(479) 968-2456

Fax

(479) 968-7914

NPI assigned

Sep 15, 2006

Organization subpart

No

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

Authorized official

Name

Roy Dean Walker, RPHNPI 1619564317

Title

President

Phone

(479) 968-2456

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR2 enrollments

Enrollment records 2

Tax ID family

C D Drug Store 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.

• C & D Drug Store

  • Long Term Care Pharmacy
  • Russellville, AR
  • NPI 1871335273
  NPD tax ID

Locations

Practitioners 4

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

• Roy Dean Walker, PD

  • Pharmacist
  • Russellville, AR
  • NPI 1619564317
  NPD Authorized official
• Mary Katelyn Coulter, PHARMD

  • Pharmacist
  • Russellville, AR
  • NPI 1326770124
  NPD (past)
• John Walker

  • Pharmacist
  • Russellville, AR
  • NPI 1306512637
  NPD (past)
• Yanci Leigh Walker, PHARM.D.

  • Pharmacist
  • Russellville, AR
  • NPI 1922198050
  NPD (past)

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343865600000",
    "number": "1295831899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 N COMMERCE AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013741",
            "telephone_number": "479-968-2456",
            "fax_number": "479-968-7914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N COMMERCE AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013741",
            "telephone_number": "479-968-2456",
            "fax_number": "479-968-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C & D DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2012-08-02",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-968-2456",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR05882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124449716",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100080407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shyann Alexus Bush
• Benjamin Butler, CMP
• Emily Elizabeth Butler
• Brooka Louise Byford, RBT
• C & D Drug Store
• Shelbi Lynn Cain
• Jordan Elizabeth Caldarera
• Allison Caldwell
• Jody Carlton Callaway, MD
• Lynn Elizabeth Callaway, RNP

• Community/Retail Pharmacy in Russellville, AR
• Providers in Russellville, 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 Aug 2, 2012; 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.