J J J Smith Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

AR20709 Issued in AR

Legal business name

J J J SMITH INC

Doing business as

Smith Family Pharmacy

Practice address

2425 Dave Ward Dr St 602
Conway, AR 72034

Phone

(501) 336-8188

Fax

(501) 336-8177

NPI assigned

Mar 20, 2013

Last updated

May 3, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Blake Johnson, PHARM. D.NPI 1043819923

Title

Owner / Pharmacist

Phone

(501) 336-8188

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Smith Family Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in AR2 enrollments

Enrollment records 2

Tax ID family

J J J Smith Inc3 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.

• J J J Smith, Inc

  dba Smith Family Pharmacy LTC

  • Long Term Care Pharmacy
  • Conway, AR
  • NPI 1770280349
  NPD tax ID
• JJJ Smith, Inc

  dba Central Pharmacy

  • Pharmacist
  • Conway, AR
  • NPI 1790776912
  NPD tax ID

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.

• Robert Blake Johnson, PHARM.D.

  • Pharmacist
  • Conway, AR
  • NPI 1043819923
  Authorized official Same address or phone

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651536000000",
    "number": "1790027449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 DAVE WARD DRIVE ST 602",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "72034",
            "telephone_number": "501-336-8188",
            "fax_number": "501-336-8177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 DAVE WARD DR ST 602",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "72034",
            "telephone_number": "501-336-8188",
            "fax_number": "501-336-8177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J J J SMITH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-20",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "OWNER / PHARMACIST",
        "authorized_official_telephone_number": "501-336-8188",
        "authorized_official_credential": "PHARM. D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR20709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01689342",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2139577",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smith Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Smith Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah M Isgrig, BT
• Amr Ismail, M.D.
• Daria Isom, CASE MANAGER PARAPRO
• Sara Fairbanks Israel, OTR/L
• J Henry Counseling, PLLC (Copper Door Counseling)
• J J J Smith, Inc (Smith Family Pharmacy LTC)
• Jackie Coombe-Moore PA (Conway Psychiatric Center)
• Antwanette Jackson
• Ashley Hoelzeman Jackson, PHARM D.
• Brandon Jackson

• Community/Retail Pharmacy in Conway, AR
• Providers in Conway, 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 May 3, 2022; 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.