Active NPI
Russell Franklin Green, BS
- Pharmacist
- Jonesboro, AR
National Provider Identifier
1376801753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD06430
- Practice address
- 2308 S Caraway Rd
Jonesboro, AR 72401-6205 - Phone
- (870) 972-8751
- Fax
- (870) 972-1285
- NPI assigned
- Apr 24, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PD06430 | AR | Primary |
Addresses
Primary practice location
2308 S Caraway Rd
Jonesboro, AR 72401-6205
Mailing address
2308 S Caraway Rd
Jonesboro, AR 72401-6205
Phone (870) 972-8751
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PD06430 | AR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Freds Stores of Tennessee Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Greenville, MS
- NPI 1093969016
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337731200000",
"number": "1376801753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2308 S CARAWAY RD",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724016205",
"telephone_number": "870-972-8751",
"fax_number": "870-972-1285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2308 S CARAWAY RD",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724016205",
"telephone_number": "870-972-8751",
"fax_number": "870-972-1285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "RUSSELL",
"middle_name": "FRANKLIN",
"name_prefix": "Mr.",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-24",
"last_updated": "2012-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD06430",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 May 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.