West Side Pharmacy, Inc.

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

AR01745 Issued in AR

Legal business name

WEST SIDE PHARMACY, INC.

Doing business as

West Side Pharmacy

Practice address

620 W South St Ste C
Benton, AR 72015-4235

Phone

(501) 778-3151

Fax

(501) 778-7329

NPI assigned

Aug 4, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark Haynes

Title

Office Manager

Phone

(501) 778-8062

Specialties & licenses 1

Addresses

Other names 1

• West Side Pharmacy Doing business as

Tax ID family

Westside Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• West Side Pharmacy, Inc.

  dba West Side Clinical Services

  • Family Medicine Physician
  • Benton, AR
  • NPI 1366060576
  NPD tax ID

Locations

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750399515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W SOUTH ST STE C",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720154235",
            "telephone_number": "501-778-3151",
            "fax_number": "501-778-7329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W SOUTH ST STE C",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720154235",
            "telephone_number": "501-778-3151",
            "fax_number": "501-778-7329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST SIDE PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "501-778-8062"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "AR",
            "license": "AR01745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Side Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• West Side Pharmacy Inc.
• West Side Pharmacy Incorporated (West Side Pharmacy)
• West Side Pharmacy- Military Road LLC
• West Side Pharmacy- Military Road LLC
• West Side Pharmacy, Inc. (West Side Clinical Services)
• Christina Hyde West, MA CCC SLP
• Wendy M West, APN
• Tyler Nichole Westbrook, PHARMD
• Kimberly Westbrooks, RECOVERY ASSISTANT
• Aurielle Dominique Westfall, RN

• Long Term Care Pharmacy in Benton, AR
• Providers in Benton, AR by specialty
• Long Term Care Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.