Red River Pharmacy of Jonesboro LLC

Primary specialty

Nuclear PharmacyTaxonomy code 3336N0007X

Legal business name

RED RIVER PHARMACY OF JONESBORO LLC

Practice address

2908 S Caraway Rd
Jonesboro, AR 72401-7346

Phone

(870) 336-2195

Fax

(870) 336-2197

NPI assigned

Sep 2, 2016

Organization subpart

No

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

Authorized official

Name

David Boudreaux

Title

President

Phone

(903) 792-7435

Specialties & licenses 6

Addresses

Other identifiers 2

Other names 2

• Red River Infusion Pharmacy of Jonesboro Doing business as
• Red River Pharmacy of Jonesboro Doing business as

Medicare fee-for-service enrollment

Enrolled in AR2 enrollments

Home infusion therapy

Medicare-enrolled home infusion therapy supplier

Enrollment records 2

Tax ID family

Red River Pharmacy of Jonesboro LLC3 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.

• Red River Pharmacy of Jonesboro LLC

  • Home Infusion Therapy Pharmacy
  • Jonesboro, AR
  • NPI 1437745296
  NPD tax ID
• Red River Pharmacy of Jonesboro LLC

  • Durable Medical Equipment & Medical Supplies
  • Jonesboro, AR
  • NPI 1588210686
  NPD tax ID

Locations

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

{
    "created_epoch": "1472774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746576000000",
    "number": "1609323922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034657",
            "telephone_number": "903-792-7435",
            "fax_number": "903-793-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2908 S CARAWAY RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017346",
            "telephone_number": "870-336-2195",
            "fax_number": "870-336-2197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED RIVER PHARMACY OF JONESBORO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-02",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A",
        "authorized_official_last_name": "BOUDREAUX",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-792-7435"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AR",
            "license": "AR20653",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336N0007X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Nuclear Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2164238",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "7627810001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red River Infusion Pharmacy of Jonesboro",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Red River Pharmacy of Jonesboro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Margaret B Rector, PH.D
• Red River Health, LLC
• Red River Pharmacy Long Term Care, LLC
• Red River Pharmacy of Jonesboro LLC
• Red River Pharmacy of Jonesboro LLC
• Jordan Redd
• Vershandale Redden
• Jessica Reddick, LPN
• Taylor Reddick
• Tiffany L Reddick

• Pharmacy in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.