James Abbott

Individual provider Active NPI Pharmacist · Conway, AR

NPI 1962090852 · NPPES record last updated Jan 6, 2021

Key facts

NPI
1962090852
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
PD12335 (AR)
Practice address
2235 Dave Ward Dr Ste 108
Conway, AR 72034-7040
Phone
(501) 450-0000
NPI assigned
Jan 6, 2021
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PD12335ARMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
PPG Store 6 LLC Past
since Jan 10, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PD12335 AR Yes

Addresses

Primary practice location

2235 Dave Ward Dr Ste 108
Conway, AR 72034-7040

Mailing address

2235 Dave Ward Dr Ste 108
Conway, AR 72034-7040
Phone (501) 450-0000

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address conway@heartland-rx.com Direct

Other providers in Conway, AR

All providers in Conway, AR · Pharmacist in Arkansas

Sources for this page

Verify at the official NPI Registry.