Active NPI
Mary Carole M Polk, RPH
- Pharmacist
- Clarendon, AR
National Provider Identifier
1770685083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 7925
- Practice address
- 333 Madison Street
Clarendon, AR 72029 - Phone
- (870) 747-3304
- NPI assigned
- Sep 5, 2006
- Last updated
- Dec 27, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 7925 | AR | Primary |
Addresses
Primary practice location
333 Madison Street
Clarendon, AR 72029
Mailing address
55 Normandy LN
Little Rock, AR 72207-4201
Phone (501) 690-7519
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7925 | AR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735257600000",
"number": "1770685083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 NORMANDY LN",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722074201",
"telephone_number": "501-690-7519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 MADISON STREET",
"city": "CLARENDON",
"state": "AR",
"postal_code": "72029",
"telephone_number": "870-747-3304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLK",
"first_name": "MARY CAROLE",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-05",
"last_updated": "2024-12-27",
"certification_date": "2024-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "7925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarendon, AR
- Thomas P Patten, DDS
- Summer N Patton, RDN, LDN
- Polk Pharmacy Management
- Polk Pharmacy Management, LLC (Long Term Care Middleton Rx)
- Polk Pharmacy Management, LLC (Polk Pharmacy)
- Curtis Andrew Schalchlin, M.D.
- Spot LLC
- Stuttgart Regional Medical Center (Clarendon Medical Clinic)
- Skylar Aspen Vanderburg, CNP
- Jill R Vandesteeg
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.