NPIMap

Organization Active NPI

Blandford Pharmacy

Doing business as Blanford Pharmacy

  • Community/Retail Pharmacy
  • Little Rock, AR
National Provider Identifier
1750450607
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
AR13283 Issued in AR
Legal business name
BLANDFORD PHARMACY
Doing business as
Blanford Pharmacy
Practice address
5 Saint Vincent Cir
Ste 110
Little Rock, AR 72205-5412
Phone
(501) 664-4466
Fax
(501) 664-2360
NPI assigned
Nov 7, 2006
Last updated
Mar 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Authorized official

Name
Keith SholesNPI 1467832170
Title
Owner Phcst
Phone
(501) 664-4466

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X AR13283 AR Primary

Addresses

Primary practice location

5 Saint Vincent Cir
Ste 110
Little Rock, AR 72205-5412

Mailing address

5 Saint Vincent Cir
Ste 110
Little Rock, AR 72205-5412
Phone (501) 664-4466

Other identifiers 2

IdentifierTypeStateIssuer
110965407MedicaidAR
1994349OtherPK

Other names 1

  • BLANFORD PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

5 Saint Vincent Cir
Ste 110
Little Rock, AR 72205
Phone (501) 664-4466

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": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489968000000",
    "number": "1750450607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SAINT VINCENT CIR",
            "address_2": "STE 110",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055412",
            "telephone_number": "501-664-4466",
            "fax_number": "501-664-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SAINT VINCENT CIR",
            "address_2": "STE 110",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055412",
            "telephone_number": "501-664-4466",
            "fax_number": "501-664-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLANDFORD PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2017-03-20",
        "status": "A",
        "authorized_official_last_name": "SHOLES",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "OWNER PHCST",
        "authorized_official_telephone_number": "501-664-4466"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR13283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110965407",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1994349",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLANFORD PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; 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.