Active NPI
Whitehall Pharmacy LLC
- Community/Retail Pharmacy
- Pine Bluff, AR
National Provider Identifier
1447590146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- AR20708
- Legal business name
- WHITEHALL PHARMACY LLC
- Practice address
- 2302 W 28TH Ave Ste B
Pine Bluff, AR 71603-5081 - Phone
- (870) 671-4914
- Fax
- (870) 671-4917
- NPI assigned
- Feb 18, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Floyd Stice
- Title
- Pharmacist Owner
- Phone
- (501) 442-4657
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | AR20708 | AR | Primary |
Addresses
Primary practice location
2302 W 28TH Ave Ste B
Pine Bluff, AR 71603-5081
Mailing address
2302 W 28TH Ave Ste B
Pine Bluff, AR 71603-5081
Phone (870) 671-4914
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 197607407 | Medicaid | AR | |
| 2138758 | Other | PK |
Other names 1
- Doctor's Orders Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130515000063 | AR | Part B Supplier - Mass Immunization (Roster Biller Only) | 0840320537 | Practice locations: Pine Bluff, AR |
| O20230505001048 | AR | Part B Supplier - Independent Clinical Laboratory | 0840320537 |
3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: White Hall, AR; Pine Bluff, AR; Star City, AR |
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361145600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1680566400000",
"number": "1447590146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2302 W 28TH AVE STE B",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716035081",
"telephone_number": "870-671-4914",
"fax_number": "870-671-4917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2302 W 28TH AVE STE B",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716035081",
"telephone_number": "870-671-4914",
"fax_number": "870-671-4917"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WHITEHALL PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-02-18",
"last_updated": "2023-04-04",
"certification_date": "2023-04-04",
"status": "A",
"authorized_official_last_name": "STICE",
"authorized_official_first_name": "FLOYD",
"authorized_official_title_or_position": "PHARMACIST OWNER",
"authorized_official_telephone_number": "501-442-4657"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "AR",
"license": "AR20708",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "197607407",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2138758",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Doctor's Orders Pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Doctor's Orders Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Pine Bluff, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; 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.