NPIMap

Organization Active NPI

The Functional Pharmacist Inc

  • Clinic/Center
  • Lake Village, AR
National Provider Identifier
1780228346
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
THE FUNCTIONAL PHARMACIST INC
Practice address
401 Main St
Lake Village, AR 71653-1731
Phone
(870) 265-6603
NPI assigned
Nov 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Authorized official

Name
Michelle Crouse, PHARMDNPI 1790714095
Title
Owner
Phone
(870) 265-6603

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

401 Main St
Lake Village, AR 71653-1731

Mailing address

401 Main St
Lake Village, AR 71653-1731
Phone (870) 265-6603

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574726400000",
    "number": "1780228346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 MAIN ST",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716531731",
            "telephone_number": "870-265-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MAIN ST",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716531731",
            "telephone_number": "870-265-6603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FUNCTIONAL PHARMACIST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-06",
        "last_updated": "2019-11-26",
        "status": "A",
        "authorized_official_last_name": "CROUSE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-265-6603",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Village, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.