Saint-Mark Enterprises 1890 LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SAINT-MARK ENTERPRISES 1890 LLC

Doing business as

Medicine Shoppe

Practice address

2425 Dave Ward Dr
Suite 602
Conway, AR 72034-8686

Phone

(501) 329-7777

NPI assigned

Jan 8, 2009

Last updated

Feb 1, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

SAINT-MARK ENTERPRISES LLCAs reported in NPPES

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

Authorized official

Name

Mark A Miller

Title

Owner

Phone

(314) 518-2427

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• MEDICINE SHOPPE Doing business as

Locations

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328054400000",
    "number": "1902043227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630250098",
            "telephone_number": "314-518-2427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 DAVE WARD DR",
            "address_2": "SUITE 602",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720348686",
            "telephone_number": "501-329-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT-MARK ENTERPRISES 1890 LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAINT-MARK ENTERPRISES LLC",
        "enumeration_date": "2009-01-08",
        "last_updated": "2012-02-01",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-518-2427"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175898407",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP #",
            "identifier": "0423044",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICINE SHOPPE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sammye B Ryals, DAY TREATMENT SUPERV
• Ahmad Haythem Saadeh, MD
• Nicholas J Sachse, OD
• Sacred Trust Christian Counseling
• Kara Aspen Sain
• Saint-Mark Enterprises 1906 LLC (Medicine Shoppe)
• Ryan Salami, CMP
• Madison Grace Salazar
• Salem Place Nursing and Rehabilitation Center Inc
• Ahmed Salem, PHARMD, MPH

• Community/Retail Pharmacy in Conway, AR
• Providers in Conway, AR by specialty
• Community/Retail Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; 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.