Organization Active NPI

Family Medical Center Pharmacy Inc

  • Pharmacist
  • Little Rock, AR
National Provider Identifier
1801970413
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
Legal business name
FAMILY MEDICAL CENTER PHARMACY INC
Practice address
3016 S University Ave
Little Rock, AR 72204-7841
Phone
(501) 562-3314
Fax
(501) 565-4951
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Authorized official

Name
Melissa Smith
Title
Owner/Pharmacist
Phone
(501) 562-3314

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X PD08700 AR
PharmacistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 183500000X Primary

Addresses

Primary practice location

3016 S University Ave
Little Rock, AR 72204-7841

Mailing address

3016 S University Ave
Little Rock, AR 72204-7841
Phone (501) 562-3314

Other identifiers 1

IdentifierTypeStateIssuer
112086407MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240322000724 AR Part B Supplier - Mass Immunization (Roster Biller Only) 0941647267 Practice locations: Little Rock, AR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2303654Family Medical Center Pharmacy Inc3016 S University Ave, Little Rock, AR 72204Certificate of waiverApr 28, 2028

National Provider Directory

National Provider Directory

Locations

3016 S University Ave
Little Rock, AR 72204
Phone (501) 412-3906

Practitioners & affiliated clinicians

Practitioners 1

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": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713139200000",
    "number": "1801970413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 S UNIVERSITY AVE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722047841",
            "telephone_number": "501-562-3314",
            "fax_number": "501-565-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3016 S UNIVERSITY AVE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722047841",
            "telephone_number": "501-562-3314",
            "fax_number": "501-565-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL CENTER PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "501-562-3314"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD08700",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112086407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.