Rose Drug of Dover, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

AR20230 Issued in AR

Legal business name

ROSE DRUG OF DOVER, INC

Practice address

417 Union St
Dardanelle, AR 72834-3429

Phone

(479) 228-4811

Fax

(479) 229-5871

NPI assigned

Aug 29, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Richard L Harmon, P.D.

Title

Pharmacist/Owner

Phone

(479) 229-4811

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• BERRY DRUG OF DARDANELLE Doing business as

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1881703379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 UNION ST",
            "city": "DARDANELLE",
            "state": "AR",
            "postal_code": "728343429",
            "telephone_number": "479-229-4811",
            "fax_number": "479-229-5871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 UNION ST",
            "city": "DARDANELLE",
            "state": "AR",
            "postal_code": "728343429",
            "telephone_number": "479-228-4811",
            "fax_number": "479-229-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE DRUG OF DOVER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "HARMON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "479-229-4811",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR20230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139822407",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "0421052",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RETAIL PHARMACY LICENSE",
            "identifier": "AR20230",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BERRY DRUG OF DARDANELLE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BERRY DRUG OF DARDANELLE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kaci Rood, PHARM D
• Rose Drug of Dover, Inc
• William Patrick Scott, MD
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• Matthew Self, MD
• Jill M Sheets, P.D.
• Tanna Shockley, APRN

• All providers in Dardanelle, AR
• Community/Retail Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.