NPIMap

Organization Active NPI

Supermarket Investors Inc

  • Pharmacy
  • Sherwood, AR
National Provider Identifier
1891843892
Registry record updated Mar 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
AR20127 Issued in AR
Legal business name
SUPERMARKET INVESTORS INC
Doing business as
HARVEST FOODS PHARMACY
Practice address
4101 E Kiehl Ave
Sherwood, AR 72120-3539
Phone
(501) 835-2630
Fax
(501) 835-2681
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2009

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

Authorized official

Name
Brenda McCrady, BS PHARMACY
Title
Director of Pharmacy
Phone
(501) 570-0007

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X AR20127 AR Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

4101 E Kiehl Ave
Sherwood, AR 72120-3539

Mailing address

4101 E Kiehl Ave
Sherwood, AR 72120-3539

Other identifiers 3

IdentifierTypeStateIssuer
150860716MedicaidAR
0420252OtherOTHER ID NUMBER-COMMERCIAL NUMBER
134908407MedicaidAR

Other names 1

  • HARVEST FOODS PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Harvest Foods Pharmacy13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

4101 E Kiehl Ave
Sherwood, AR 72120
Phone (501) 835-2630

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236297600000",
    "number": "1891843892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 E KIEHL AVE",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721203539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 E KIEHL AVE",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721203539",
            "telephone_number": "501-835-2630",
            "fax_number": "501-835-2681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERMARKET INVESTORS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2009-03-06",
        "status": "A",
        "authorized_official_last_name": "MCCRADY",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "501-570-0007",
        "authorized_official_credential": "BS PHARMACY"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AR",
            "license": "AR20127",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150860716",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0420252",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134908407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HARVEST FOODS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sherwood, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; 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.