NPIMap

Organization Active NPI

Red River Pharmacy Long Term Care, LLC

  • Long Term Care Pharmacy
  • Little Rock, AR
National Provider Identifier
1851097794
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
RED RIVER PHARMACY LONG TERM CARE, LLC
Doing business as
Red River LTC of Little Rock
Practice address
1515 S Bowman Rd Ste D
Little Rock, AR 72211-4227
Phone
(501) 712-4582
Fax
(833) 701-0126
NPI assigned
Feb 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Authorized official

Name
Robin Brule
Title
Cfo
Phone
(903) 792-7435

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

1515 S Bowman Rd Ste D
Little Rock, AR 72211-4227

Mailing address

1550 Moores LN
Texarkana, TX 75503-4657
Phone (903) 792-1721

Other names 1

  • Red River LTC of Little Rock Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241028000538 AR Part B Supplier - Pharmacy 2860827417 Practice locations: Little Rock, AR

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Red River Pharm LTC LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1515 S Bowman Rd
Ste D
Little Rock, AR 72211
Phone (903) 792-9110

NPI Registry JSON

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683158400000",
    "number": "1851097794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034657",
            "telephone_number": "903-792-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 S BOWMAN RD STE D",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114227",
            "telephone_number": "501-712-4582",
            "fax_number": "833-701-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED RIVER PHARMACY LONG TERM CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A",
        "authorized_official_last_name": "BRULE",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "903-792-7435"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red River LTC of Little Rock",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Red River LTC of Little Rock",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 4, 2023; 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.