Individual provider Active NPI

Jeffery L. Price, PHARM.D.

  • Pharmacist
  • Holiday Island, AR
National Provider Identifier
1790032175
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PD08764 Issued in AR
Practice address
2 Forest Park Dr Ste a
Holiday Island, AR 72631-9229
Phone
(479) 239-2121
Fax
(479) 239-2122
NPI assigned
Aug 5, 2012
Last updated
Sep 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PD08764 AR Primary

Addresses

Primary practice location

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

Mailing address

2 Forest Park Dr Ste a
Holiday Island, AR 72631-9229
Phone (479) 239-2121

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PD08764ARMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Holiday Island Pharmacy, LLC CurrentSince Sep 23, 2021 Accepting new patients

Locations

2 Forest Park Dr
Ste A
Holiday Island, AR 72631
Phone (479) 239-2121

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1344124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1790032175",
    "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": {
        "last_name": "PRICE",
        "first_name": "JEFFERY",
        "middle_name": "L.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-05",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD08764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holiday Island, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.