Active NPI
Conway Medcare Pharmacy, LLC
- Community/Retail Pharmacy
- Conway, AR
National Provider Identifier
1659619120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- AR20700
- Legal business name
- CONWAY MEDCARE PHARMACY, LLC
- Practice address
- 2521 College Ave
Conway, AR 72034-6135 - Phone
- (501) 358-3498
- Fax
- (501) 358-3506
- NPI assigned
- Jan 17, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Matthew Thomas Frazier, PHARMD
- Title
- Pharmacist
- Phone
- (501) 472-7980
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | AR20700 | AR | Primary |
Addresses
Primary practice location
2521 College Ave
Conway, AR 72034-6135
Mailing address
PO Box 878
Conway, AR 72033-0878
Phone (501) 358-3498
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131004000031 | AR | Part B Supplier - Mass Immunization (Roster Biller Only) | 8224262373 | Practice locations: Conway, AR |
National Provider Directory
National Provider Directory- Tax ID family
- Conway Medcare Pharmacy LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Conway, AR
- NPI 1356146484
Locations
2521 College Ave
Conway, AR 72034
Phone (501) 358-3498
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Conway, AR
- NPI 1558708149
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358380800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1358380800000",
"number": "1659619120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 878",
"city": "CONWAY",
"state": "AR",
"postal_code": "720330878",
"telephone_number": "501-358-3498",
"fax_number": "501-358-3506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2521 COLLEGE AVE",
"city": "CONWAY",
"state": "AR",
"postal_code": "720346135",
"telephone_number": "501-358-3498",
"fax_number": "501-358-3506"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CONWAY MEDCARE PHARMACY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-01-17",
"last_updated": "2013-01-17",
"status": "A",
"authorized_official_last_name": "FRAZIER",
"authorized_official_first_name": "MATTHEW",
"authorized_official_middle_name": "THOMAS",
"authorized_official_title_or_position": "PHARMACIST",
"authorized_official_telephone_number": "501-472-7980",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "AR",
"license": "AR20700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; 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.