Gurdon Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

GURDON PHARMACY LLC

Practice address

104 S. 6TH St
Gurdon, AR 71743

Phone

(870) 353-9900

Fax

(844) 805-7807

NPI assigned

Dec 9, 2020

Last updated

Apr 11, 2022By 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

Todd Beagle

Title

Pharmacy Operations Manager

Phone

(309) 642-2620

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 1

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.

• Larry Roy Thomerson, RPH

  • Pharmacist
  • Gurdon, AR
  • NPI 1053058727
  NPD

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649635200000",
    "number": "1487250015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S. 6TH ST",
            "city": "GURDON",
            "state": "AR",
            "postal_code": "71743",
            "telephone_number": "870-353-9900",
            "fax_number": "844-805-7807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S. 6TH ST",
            "city": "GURDON",
            "state": "AR",
            "postal_code": "71743",
            "telephone_number": "870-353-9900",
            "fax_number": "844-805-7807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GURDON PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-09",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "BEAGLE",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "PHARMACY OPERATIONS MANAGER",
        "authorized_official_telephone_number": "309-642-2620"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262898407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peytyn Daniell
• Leah Dorsey, MCD, CCC-SLP
• Kimberly Garlin
• Great Beginnings Child Care & Enrichment Center, Inc.
• Gurdon Family Dentistry, Inc
• Yanira Harper, QBHP
• Hours of Joy Child Care Inc. (Health Care Services)
• Hours of Joy Child Care Inc. (Linda Harris)
• Sara Elizabeth Liggin, SLP
• Laura Lucia Rivera, COTA/L

• Community/Retail Pharmacy in Gurdon, AR
• Providers in Gurdon, 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 Apr 11, 2022; 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.