Rose Drug of Russellville, Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

ROSE DRUG OF RUSSELLVILLE, INC

Practice address

3103 W Main PL
Russellville, AR 72801-3360

Phone

(479) 968-1323

Fax

(479) 968-1557

NPI assigned

Aug 3, 2023

Last updated

May 9, 2024By 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

Randy Issa Kassissieh, PHARMD

Title

Owner

Phone

(479) 968-1323

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1691020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1518649193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3103 W MAIN PL",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013360",
            "telephone_number": "479-968-1323",
            "fax_number": "479-968-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3103 W MAIN PL",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013360",
            "telephone_number": "479-968-1323",
            "fax_number": "479-968-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE DRUG OF RUSSELLVILLE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-03",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A",
        "authorized_official_last_name": "KASSISSIEH",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "ISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-968-1323",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosemary A Rolniak, PHYSICAL THERAPIST
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• Ryan Matthew Rooke, COTA
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• Rose Drug of Russellville Inc
• Rose Drug of Russellville, Inc
• Kelsey Marissa Ross
• Stephanie A. Roth, DPM
• Mittie Rowland
• Kenneth Roy, M.A. LAC

• Long Term Care Pharmacy in Russellville, AR
• Providers in Russellville, AR by specialty
• Long Term Care Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.