Mitchell's Main Street Pharmacy, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

AR14641 Issued in AR

Legal business name

MITCHELL'S MAIN STREET PHARMACY, INC

Doing business as

Mitchell's Main Street Pharmacy

Practice address

214 East Main St
Mountain View, AR 72560

Phone

(870) 269-3253

Fax

(870) 269-5120

NPI assigned

Oct 22, 2012

Last updated

Mar 4, 2013By 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

Eddie Mitchell

Title

President

Phone

(870) 269-3253

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mitchell's Main Street Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in AR2 enrollments

Enrollment records 2

Tax ID family

Mitchell's Main Street 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.

• Mitchell's Main Street Pharmacy LTC, Inc

  • Long Term Care Pharmacy
  • Mountain View, AR
  • NPI 1477319861
  NPD tax ID

Locations

Practitioners 2

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.

• Edward Mitchell, PHARM.D

  • Pharmacist
  • Mountain View, AR
  • NPI 1497351159
  NPD
• Whitney Leeann Holland, PHARMD

  • Pharmacist
  • Clinton, AR
  • NPI 1609476720
  NPD (past)

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362355200000",
    "number": "1447503941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2798",
            "city": "MOUNTAIN VIEW",
            "state": "AR",
            "postal_code": "725602798",
            "telephone_number": "870-269-3253",
            "fax_number": "870-269-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 EAST MAIN ST",
            "city": "MOUNTAIN VIEW",
            "state": "AR",
            "postal_code": "72560",
            "telephone_number": "870-269-3253",
            "fax_number": "870-269-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELL'S MAIN STREET PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-22",
        "last_updated": "2013-03-04",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-269-3253"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR14641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0424111",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mitchell's Main Street Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Lee Merryman, BA
• Alison Miller
• David W Mitchell, OTR/L
• Edward Mitchell, PHARM.D
• Mitchell's Main Street Pharmacy LTC, Inc
• Karla Mixon
• Elizabeth Mizell
• Moore DME LLC
• Anise Moore
• Heather Morgan

• Community/Retail Pharmacy in Mountain View, AR
• Providers in Mountain View, 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 Mar 4, 2013; 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.