NPIMap

Organization Active NPI

Econo-Mart Pharmacy Inc

  • Community/Retail Pharmacy
  • Batesville, AR
National Provider Identifier
1679568729
Registry record updated Dec 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
AR14083 Issued in AR
Legal business name
ECONO-MART PHARMACY INC
Practice address
1595 Harrison St
Batesville, AR 72501-7222
Phone
(870) 793-4179
Fax
(870) 793-7303
NPI assigned
Sep 14, 2005
Last updated
Dec 26, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2018

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

Authorized official

Name
Paul Holifield, PHARMDNPI 1902857527
Title
Owner
Phone
(870) 793-4179

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X AR14083 AR Primary
Long Term Care Pharmacy 3336L0003X NU
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

1595 Harrison St
Batesville, AR 72501-7222

Mailing address

1595 Harrison St
Batesville, AR 72501-7222
Phone (870) 793-4179

Other identifiers 2

IdentifierTypeStateIssuer
1994551OtherPK
100761467MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20071220000095 AR Part B Supplier - Mass Immunization (Roster Biller Only) 3274623798 Practice locations: Batesville, AR
O20100930075630 AR DME Supplier - Pharmacy 3274623798 Practice locations: Batesville, AR
O20220127001082 AR Part B Supplier - Independent Clinical Laboratory 3274623798 Practice locations: Batesville, AR

National Provider Directory

National Provider Directory
Tax ID family
Econo-Mart 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.

Practitioners & affiliated clinicians

Practitioners 1

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": "1126656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545782400000",
    "number": "1679568729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 HARRISON ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017222",
            "telephone_number": "870-793-4179",
            "fax_number": "870-793-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 HARRISON ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017222",
            "telephone_number": "870-793-4179",
            "fax_number": "870-793-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECONO-MART PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-14",
        "last_updated": "2018-12-26",
        "status": "A",
        "authorized_official_last_name": "HOLIFIELD",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-793-4179",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR14083",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1994551",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100761467",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; 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.