Collier Drug Stores Inc
Organization Active NPI Community/Retail Pharmacy · Elkins, AR
NPI 1588091201 · NPPES record last updated Feb 20, 2024
Key facts
- NPI
- 1588091201
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- AR20729 (AR)
- Legal business name
- COLLIER DRUG STORES INC
- Practice address
- 2491 N. Center Street
Elkins, AR 72727 - Phone
- (479) 442-6060
- Fax
- (479) 442-0606
- NPI assigned
- Sep 27, 2013
- Organization subpart
- No
Authorized official
- Name
- Mel Collier
- Title
- Owner
- Phone
- (479) 442-6262
Other NPIs on the same Medicare enrollment 9
Corporate family (same tax ID) 18
Practitioners 1
-
Lori Ray, PHARM. D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110207000110 | AR | Part B Supplier - Mass Immunization (Roster Biller Only) | 5294889358 |
12 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Tontitown, AR; Prairie Grove, AR; Lowell, AR; Johnson, AR; Fayetteville, AR; Farmington, AR; Elkins, AR; Centerton, AR… |
National Provider Directory
- Tax ID family
- Collier Drug Stores Inc
Locations
2491 N Center St
Fayetteville, AR 72701
Phone (479) 442-6060
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | AR20729 | AR | Yes |
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
2491 N. Center Street
Elkins, AR 72727
Mailing address
PO Box 1085
Fayetteville, AR 72702-1085
Phone (479) 935-4303
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2142278 | Other | PK |
Other names
- Collier Drug-Elkins
Other providers in Elkins, AR
All providers in Elkins, 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 Feb 20, 2024. 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.