Active NPI
White River Rural Health Center, Inc.
Doing business as Community Drug Store of Lake City
- Community/Retail Pharmacy
- Lake City, AR
National Provider Identifier
1508021619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- AR20585
- Legal business name
- WHITE RIVER RURAL HEALTH CENTER, INC.
- Doing business as
- Community Drug Store of Lake City
- Practice address
- 1009 Highway 18
Ste B
Lake City, AR 72437-9622 - Phone
- (870) 237-1246
- Fax
- (870) 237-1248
- NPI assigned
- Jul 29, 2008
- Last updated
- Aug 7, 2008
- Organization subpart
- Yes
- Parent organization
- WHITE RIVER RURAL HEALTH CENTER, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Steve Collier, MD
- Title
- Ceo
- Phone
- (870) 347-3304
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic Pharmacy | 3336C0002X | NU | ||
| Community/Retail Pharmacy | 3336C0003X | AR20585 | AR | Primary |
Addresses
Primary practice location
1009 Highway 18
Ste B
Lake City, AR 72437-9622
Mailing address
623 N 9TH St
Augusta, AR 72006-2129
Phone (870) 347-2534
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0422903 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names 1
- Community Drug Store of Lake City
National Provider Directory
National Provider Directory- Tax ID family
- White River Rural Healt
- Part of
- White River Rural Healt
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Locations
1009 Highway 18
Ste B
Lake City, AR 72437
Phone (870) 237-1246
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217289600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1218067200000",
"number": "1508021619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "623 N 9TH ST",
"city": "AUGUSTA",
"state": "AR",
"postal_code": "720062129",
"telephone_number": "870-347-2534",
"fax_number": "870-347-2882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1009 HIGHWAY 18",
"address_2": "STE B",
"city": "LAKE CITY",
"state": "AR",
"postal_code": "724379622",
"telephone_number": "870-237-1246",
"fax_number": "870-237-1248"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WHITE RIVER RURAL HEALTH CENTER, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WHITE RIVER RURAL HEALTH CENTER, INC.",
"enumeration_date": "2008-07-29",
"last_updated": "2008-08-07",
"status": "A",
"authorized_official_last_name": "COLLIER",
"authorized_official_first_name": "STEVE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "870-347-3304",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "3336C0002X",
"taxonomy_group": "",
"desc": "Pharmacy, Clinic Pharmacy",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "AR",
"license": "AR20585",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
"identifier": "0422903",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Community Drug Store of Lake City",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lake City, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.