Nyal Drug Store, Inc

Primary specialty

PharmacistTaxonomy code 183500000X

License

6039 Issued in AR

Legal business name

NYAL DRUG STORE, INC

Practice address

42 Frisco St
Marked Tree, AR 72365-2214

Phone

(870) 358-2135

Fax

(870) 358-4055

NPI assigned

Jul 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Randy Lee Shinabery, PD

Title

Owner

Phone

(870) 358-2135

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186358400000",
    "number": "1801816616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 FRISCO ST",
            "city": "MARKED TREE",
            "state": "AR",
            "postal_code": "723652214",
            "telephone_number": "870-358-2135",
            "fax_number": "870-358-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 FRISCO ST",
            "city": "MARKED TREE",
            "state": "AR",
            "postal_code": "723652214",
            "telephone_number": "870-358-2135",
            "fax_number": "870-358-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYAL DRUG STORE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-08-06",
        "status": "A",
        "authorized_official_last_name": "SHINABERY",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-358-2135",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PD"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "6039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PHARMACY NUMBER",
            "identifier": "0404575",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Marked Tree, AR
• Pharmacist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; 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.