NPIMap

Organization Active NPI

Collier Drug Stores Inc

Doing business as Collier Drug - Willow Creek

  • Long Term Care Pharmacy
  • Springdale, AR
National Provider Identifier
1659064236
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
COLLIER DRUG STORES INC
Doing business as
Collier Drug - Willow Creek
Practice address
5201 Willow Creek Dr
Springdale, AR 72762-0876
Phone
(479) 521-7876
Fax
(479) 521-7889
NPI assigned
May 31, 2023
Last updated
Feb 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Authorized official

Name
Carl Melvin Collier Jr.NPI 1871609925
Title
Owner
Phone
(479) 442-6262

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

5201 Willow Creek Dr
Springdale, AR 72762-0876

Mailing address

PO Box 1085
Fayetteville, AR 72702-1085
Phone (479) 442-6262

Other identifiers 1

IdentifierTypeStateIssuer
127467407MedicaidAR

Other names 1

  • Collier Drug - Willow Creek Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Collier Drug Stores Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Locations

5201 Willow Creek Dr
Springdale, AR 72762
Phone (479) 521-7876

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1659064236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1085",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727021085",
            "telephone_number": "479-442-6262",
            "fax_number": "479-521-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 WILLOW CREEK DR",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727620876",
            "telephone_number": "479-521-7876",
            "fax_number": "479-521-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLIER DRUG STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-31",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "COLLIER",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "MELVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-442-6262",
        "authorized_official_name_suffix": "Jr."
    },
    "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": "127467407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Collier Drug - Willow Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springdale, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.