Community Care RX LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

COMMUNITY CARE RX LLC

Practice address

1606 Martin Luther King Blvd
Malvern, AR 72104-2006

Phone

(501) 229-1446

Fax

(501) 229-1397

NPI assigned

Nov 3, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Shelyn Y Davis, PHARMD

Title

Pharmacist

Phone

(501) 844-1785

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Tax ID family

Community Care RX LLC3 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.

• Community Care RX

  • Primary Care Clinic/Center
  • Malvern, AR
  • NPI 1265328975
  NPD tax ID
• Community Care RX LLC

  • Long Term Care Pharmacy
  • Malvern, AR
  • NPI 1609531797
  NPD tax ID

Locations

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

{
    "created_epoch": "1541203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610323200000",
    "number": "1750859195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 MARTIN LUTHER KING BLVD",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721042006",
            "telephone_number": "501-229-1446",
            "fax_number": "501-229-1397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 MARTIN LUTHER KING BLVD",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721042006",
            "telephone_number": "501-229-1446",
            "fax_number": "501-229-1397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE RX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-03",
        "last_updated": "2021-01-11",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHELYN",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "501-844-1785",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750859195",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "shelyndavis@aol.com",
            "affiliation": "N",
            "endpointDescription": "Community Care Rx",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1606 Martin Luther King Blvd",
            "city": "Malvern",
            "state": "AR",
            "country_code": "US",
            "postal_code": "721042006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kartina Collins
• Keisha Collins
• Sheila Mae Collins, PD
• Community Care RX
• Community Care RX LLC
• David Conley, MAINTENANCE AIDE
• Doris Gail Conway, LPN
• Paula Conway
• Teresa Cook, PROGRAM TECH./MHPP
• Yvonne S Cook, LCSW

• Community/Retail Pharmacy in Malvern, AR
• Providers in Malvern, AR by specialty
• Community/Retail Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; 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.