Charles Edward Lee, P.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

PD08001 Issued in AR

Practice address

510 S Rogers St Ste 3
Clarksville, AR 72830-3792

Phone

(479) 647-3138

Fax

(479) 647-3144

NPI assigned

Dec 7, 2020

Last updated

Dec 7, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clarksville Family Pharmacy Inc

  dba Clarksville Family Pharmacy

  • Community/Retail Pharmacy
  • Clarksville, AR
  • NPI 1194010421
  NPD

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1700482676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 S ROGERS ST STE 3",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728303792",
            "telephone_number": "479-647-3138",
            "fax_number": "479-647-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S ROGERS ST STE 3",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728303792",
            "telephone_number": "479-647-3138",
            "fax_number": "479-647-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "P.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD08001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Casandra Longoria, RECOVERY ASSISTANT

• Pharmacist in Clarksville, AR
• Providers in Clarksville, AR by specialty
• Pharmacist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.