Rose Drug of Dover Inc
Organization Active NPI Community/Retail Pharmacy · Dover, AR
NPI 1508970393 · NPPES record last updated May 10, 2022
Key facts
- NPI
- 1508970393
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 010491 (AR)
- Legal business name
- ROSE DRUG OF DOVER INC
- Practice address
- 8880 Market St
Dover, AR 72837-9111 - Phone
- (479) 331-2133
- Fax
- (479) 331-4003
- NPI assigned
- Aug 18, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- ROSE DRUG OF DOVER INC
Authorized official
- Name
- Dr. Richard L. Harmon, PD
- Title
- Pharmacist
- Phone
- (479) 331-2133
Other NPIs on the same Medicare enrollment 1
Practitioners 3
-
Sarah Elaine Dobbs, PHARMD
-
Johnathan Tyler Davis, PHARM.D.
-
Jennifer Leigh Tackett, PHARM.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111129000234 | AR | Part B Supplier - Mass Immunization (Roster Biller Only) | 4789897372 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Dardanelle, AR; Dover, AR |
National Provider Directory
- Part of
- Rose Drug of Dover Inc
Locations
8880 Market St
Dover, AR 72837
Phone (479) 331-2133
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 010491 | AR | Yes |
Addresses
Primary practice location
8880 Market St
Dover, AR 72837-9111
Mailing address
8880 Market St
Dover, AR 72837-9111
Phone (479) 331-2133
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 130165407 | Medicaid | AR |
Other providers in Dover, AR
- Mark Patton
- Jacqueline Pollitzer
- Jordan Michael Pridgin
- Jessica Rackley
- Rose Drug of Dover Inc
- Christine Renee Sain
- Sara Shrum
- St Marys Physician Services LLC
- Superintendent of Dover Public Schools
- Jennifer Leigh Tackett
All providers in Dover, AR · Community/Retail Pharmacy in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.