Prince Drug Store Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

AR00628 Issued in AR

Legal business name

PRINCE DRUG STORE INC

Doing business as

Prince Drug Store Inc

Practice address

1112 Towson Ave
Fort Smith, AR 72901-5002

Phone

(479) 782-9210

Fax

(479) 782-0023

NPI assigned

Oct 20, 2006

Last updated

May 23, 2016By 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

Daniel Lunsford, PDNPI 1679172076

Title

Authorized Rep Phcst

Phone

(479) 782-9210

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• PRINCE DRUG STORE INC Doing business as

Medicare fee-for-service enrollment

Enrolled in AR2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 3

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.

• Daniel Lunsford, PD

  • Pharmacist
  • Fort Smith, AR
  • NPI 1679172076
  NPD Authorized official
• Jimmy Chokbengboun, PHARMD

  • Pharmacist
  • Fort Smith, AR
  • NPI 1831821776
  NPD (past)
• Whitley Coatney

  • Pharmacist
  • Fort Smith, AR
  • NPI 1316722820
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463961600000",
    "number": "1417039298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 TOWSON AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729015002",
            "telephone_number": "479-782-9210",
            "fax_number": "479-782-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 TOWSON AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729015002",
            "telephone_number": "479-782-9210",
            "fax_number": "479-782-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCE DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2016-05-23",
        "status": "A",
        "authorized_official_last_name": "LUNSFORD",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "AUTHORIZED REP PHCST",
        "authorized_official_telephone_number": "479-782-9210",
        "authorized_official_credential": "PD"
    },
    "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": "AR00628",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100231570A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1992747",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100026407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRINCE DRUG STORE INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan K. Price, RT (R)(T)
• Bryant Prieto, LPC
• Primary Care Collective, PLLC
• Prime Physicians LLC
• Primecare Medical Solutions
• Professional Registered Nurses (PRN Medical Services)
• Professional Registered Nurses Inc (PRN Medical Services)
• Laura Pruitt, MHPP
• Jana Pschier
• Brooke Amber Pschierl, LAC

• Community/Retail Pharmacy in Fort Smith, AR
• Providers in Fort Smith, 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 May 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.