Holiday Island Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

HOLIDAY ISLAND PHARMACY, LLC

Practice address

2 Forest Park Dr Ste a
Holiday Island, AR 72631-9229

Phone

(479) 239-2121

Fax

(479) 239-2122

NPI assigned

Oct 28, 2019

Organization subpart

No

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

Authorized official

Name

Jeffery Price, PHARMDNPI 1790032175

Title

Owner/Pharmacist

Phone

(501) 425-7814

Specialties & licenses 1

Addresses

Other names 1

• Holiday Island Pharmacy Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffery L. Price, PHARM.D.

  • Pharmacist
  • Holiday Island, AR
  • NPI 1790032175
  NPD Authorized official
• Amy Johnson, RPH

  • Pharmacist
  • Holiday Island, AR
  • NPI 1902445943
  NPD

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576540800000",
    "number": "1760025274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 FOREST PARK DR STE A",
            "city": "HOLIDAY ISLAND",
            "state": "AR",
            "postal_code": "726319229",
            "telephone_number": "479-239-2121",
            "fax_number": "479-239-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 FOREST PARK DR STE A",
            "city": "HOLIDAY ISLAND",
            "state": "AR",
            "postal_code": "726319229",
            "telephone_number": "479-239-2121",
            "fax_number": "479-239-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLIDAY ISLAND PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-28",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "501-425-7814",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holiday Island Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jharry Ann Santos Gumabon, COTA/L
• Daxton Harris
• Jamie Holden, PTA
• Holiday Island Operations, LLC
• Holiday Island Operations, LLC
• Amy Johnson, RPH
• Kristin Jones, COTA
• Lindsey Jones, COTA
• Andy Langston, OD, PA
• Danyal Loftin, PTA

• Community/Retail Pharmacy in Holiday Island, AR
• Providers in Holiday Island, 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 Dec 17, 2019; 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.