Frontier Pharmacy
Organization Active NPI Community/Retail Pharmacy · Bismarck, AR
NPI 1730653155 · NPPES record last updated Apr 22, 2019
Key facts
- NPI
- 1730653155
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- FRONTIER PHARMACY
- Practice address
- 104 Millenium Park Dr
Bismarck, AR 71929 - Phone
- (501) 214-6100
- NPI assigned
- Jan 18, 2019
- Organization subpart
- No
Authorized official
- Name
- Dr. Melanie E Overley, PHARMD
- Title
- President / Pharmacist
- Phone
- (720) 254-3152
Corporate family (same tax ID) 1
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190220000082 | AR | Part B Supplier - Pharmacy | 4981942877 | Practice locations: Bismarck, AR |
| O20191111000410 | AR | Part B Supplier - Mass Immunization (Roster Biller Only) | 4981942877 | Practice locations: Bismarck, AR |
National Provider Directory
- Tax ID family
- Frontier Pharmacy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
104 Millenium Park Dr
Bismarck, AR 71929
Mailing address
104 Millenium Park Dr
Bismarck, AR 71929
Phone (501) 214-6100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AR20896 | Other | AR | STATE PHARMACY LICENSE |
| 232588407 | Medicaid | AR |
Other providers in Bismarck, AR
- Julie Dickerson
- Sabrina Dickerson
- Tracy Dutton Efird
- Miranda Victoria Franco
- Frontier Pharmacy
- Kimberlynn Goodwin
- Harmony Hill Ranch
- Harmony Hill Ranch
- Hollow Creek Treatment Center LLC
- Angela Renee Hughes
All providers in Bismarck, AR · Community/Retail Pharmacy in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.