NPIMap

Organization Active NPI

Uptown Pharmacy of Kingman , Inc

  • Community/Retail Pharmacy
  • Kingman, AZ
National Provider Identifier
1912918582
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
Y007032 Issued in AZ
Legal business name
UPTOWN PHARMACY OF KINGMAN , INC
Practice address
4495 N Bank St
Ste 1
Kingman, AZ 86409-2711
Phone
(928) 757-1131
Fax
(928) 757-1108
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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

Authorized official

Name
Chris Howard Proffit, B. S. PHARMACY
Title
Owner
Phone
(928) 757-1131

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Y007032 AZ
Community/Retail Pharmacy 3336C0003X Y007032 AZ Primary

Addresses

Primary practice location

4495 N Bank St
Ste 1
Kingman, AZ 86409-2711

Mailing address

4495 N Bank St
Ste 1
Kingman, AZ 86409-2711
Phone (928) 757-1131

Other identifiers 2

IdentifierTypeStateIssuer
235645MedicaidAZ
1988479OtherPK

Other names 1

  • UPTOWN DRUG NORTH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Uptown Drug3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

4495 N Bank St
Ste 1
Kingman, AZ 86409
Phone (928) 757-1131

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490054400000",
    "number": "1912918582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4495 N BANK ST",
            "address_2": "STE 1",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864092711",
            "telephone_number": "928-757-1131",
            "fax_number": "928-757-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4495 N BANK ST",
            "address_2": "STE 1",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864092711",
            "telephone_number": "928-757-1131",
            "fax_number": "928-757-1108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPTOWN PHARMACY OF KINGMAN , INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2017-03-21",
        "status": "A",
        "authorized_official_last_name": "PROFFIT",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-757-1131",
        "authorized_official_credential": "B. S. PHARMACY"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AZ",
            "license": "Y007032",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y007032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "235645",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1988479",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UPTOWN DRUG NORTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingman, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; 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.