NPIMap

Organization Active NPI

Mineral Springs Drug Store, Inc.

  • Pharmacy
  • Mineral Springs, AR
National Provider Identifier
1891786885
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
AR-14413 Issued in AR
Legal business name
MINERAL SPRINGS DRUG STORE, INC.
Practice address
400 Runnels Street
Mineral Springs, AR 71851-0249
Phone
(870) 287-4455
Fax
(870) 287-4721
NPI assigned
Oct 31, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Karon Dale Baxley, P.D.
Title
Owner-Pres-Pharmacist-in-Charge
Phone
(870) 287-4455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X AR-14413 AR Primary

Addresses

Primary practice location

400 Runnels Street
Mineral Springs, AR 71851-0249

Mailing address

PO Box 249
Mineral Springs, AR 71851-0249
Phone (870) 287-4455

Other names 1

  • Mineral Springs Pharmacy and Gifts Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891786885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "MINERAL SPRINGS",
            "state": "AR",
            "postal_code": "718510249",
            "telephone_number": "870-287-4455",
            "fax_number": "870-287-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 RUNNELS STREET",
            "city": "MINERAL SPRINGS",
            "state": "AR",
            "postal_code": "718510249",
            "telephone_number": "870-287-4455",
            "fax_number": "870-287-4721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINERAL SPRINGS DRUG STORE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAXLEY",
        "authorized_official_first_name": "KARON",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OWNER-PRES-PHARMACIST-IN-CHARGE",
        "authorized_official_telephone_number": "870-287-4455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "P.D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AR",
            "license": "AR-14413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mineral Springs Pharmacy and Gifts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mineral Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.