Active NPI
East Gate Pharmacy Inc
- Community/Retail Pharmacy
- Lonsdale, AR
National Provider Identifier
1902954969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- AR16936
- Legal business name
- EAST GATE PHARMACY INC
- Practice address
- 24615 Highway 5
Lonsdale, AR 72087-8017 - Phone
- (501) 922-0909
- Fax
- (501) 922-0921
- NPI assigned
- Jan 8, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Butler, PHARM.D.
- Title
- Owner
- Phone
- (501) 922-0909
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | AR16936 | AR | Primary |
Addresses
Primary practice location
24615 Highway 5
Lonsdale, AR 72087-8017
Mailing address
24615 Highway 5
Lonsdale, AR 72087-8017
Phone (501) 922-0909
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1995090 | Other | PK | |
| 128829407 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211013002725 | AR | Part B Supplier - Mass Immunization (Roster Biller Only) | 0840195392 |
1 other NPI on this enrollment Practice locations: Lonsdale, AR; Texarkana, AR |
Other NPIs with the same Medicare PAC ID 4
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Durable Medical Equipment & Medical Supplies
- Texarkana, AR
- NPI 1972054468
0840195392
-
- Oxygen Equipment & Supplies (DME)
- Hot Springs, AR
- NPI 1598166399
0840195392
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- East Gate Pharmacy Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Lonsdale, AR
- NPI 1841841715
Locations
24615 Highway 5
Lonsdale, AR 72087
Phone (501) 922-0909
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": "1773014400000",
"number": "1902954969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24615 HIGHWAY 5",
"city": "LONSDALE",
"state": "AR",
"postal_code": "720878017",
"telephone_number": "501-922-0909",
"fax_number": "501-922-0921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24615 HIGHWAY 5",
"city": "LONSDALE",
"state": "AR",
"postal_code": "720878017",
"telephone_number": "501-922-0909",
"fax_number": "501-922-0921"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EAST GATE PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-08",
"last_updated": "2026-03-09",
"certification_date": "2026-03-09",
"status": "A",
"authorized_official_last_name": "BUTLER",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "501-922-0909",
"authorized_official_credential": "PHARM.D."
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "AR",
"license": "AR16936",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "1995090",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "128829407",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lonsdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2026; 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.