Organization Active NPI

West End Associates, Inc.

  • Long Term Care Pharmacy
  • Jonesboro, AR
National Provider Identifier
1578334751
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
WEST END ASSOCIATES, INC.
Practice address
619 W Nettleton Ave
Jonesboro, AR 72401-3970
Phone
(870) 932-4742
Fax
(870) 931-0311
NPI assigned
Jan 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Tracy Don Mooneyham, PHARM.D.
Title
Pharmacist-in-Charge
Phone
(870) 932-4742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

619 W Nettleton Ave
Jonesboro, AR 72401-3970

Mailing address

619 W Nettleton Ave
Jonesboro, AR 72401-3970
Phone (870) 932-4742

Other identifiers 1

IdentifierTypeStateIssuer
198278407MedicaidAR

Other names 1

  • Soo's West End Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Soo'S West End Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1578334751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 W NETTLETON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013970",
            "telephone_number": "870-932-4742",
            "fax_number": "870-931-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 W NETTLETON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013970",
            "telephone_number": "870-932-4742",
            "fax_number": "870-931-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST END ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "MOONEYHAM",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "DON",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARGE",
        "authorized_official_telephone_number": "870-932-4742",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198278407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Soo's West End Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.