Tommys Rexall Drug Company Inc.

Primary specialty

PharmacistTaxonomy code 183500000X

License

AR14071 Issued in AR

Legal business name

TOMMYS REXALL DRUG COMPANY INC.

Practice address

220 Court SQ
Dewitt, AR 72042-2057

Phone

(870) 946-4221

Fax

(870) 946-1181

NPI assigned

Jan 12, 2007

Last updated

Sep 1, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Tommy Glenn Black, P.D.

Title

Pharmacist

Phone

(870) 946-4221

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Tommys Rexall Drug Company Inc

  • Durable Medical Equipment & Medical Supplies
  • De Witt, AR
  • NPI 1396882122

  7416076344

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Tommys Rexall Drug Company Inc

  • Durable Medical Equipment & Medical Supplies
  • De Witt, AR
  • NPI 1396882122

  O20160726003102

  Same enrollment

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vernon Dewayne Crowell Jr., PHARMD

  • Pharmacist
  • De Witt, AR
  • NPI 1336787308
  NPD (past)
• James Mackenzie Daugherty, PHARM.D

  • Pharmacist
  • De Witt, AR
  • NPI 1497476204
  NPD (past)
• Kristi Leigh Whitmore, PHARM.D.

  • Pharmacist
  • De Witt, AR
  • NPI 1013556042
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504224000000",
    "number": "1962553404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 COURT SQ",
            "city": "DEWITT",
            "state": "AR",
            "postal_code": "720422057",
            "telephone_number": "870-946-4221",
            "fax_number": "870-946-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 COURT SQ",
            "city": "DEWITT",
            "state": "AR",
            "postal_code": "720422057",
            "telephone_number": "870-946-4221",
            "fax_number": "870-946-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOMMYS REXALL DRUG COMPANY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2017-09-01",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "TOMMY",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "870-946-4221",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.D."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "AR14071",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stan W Burleson MD PA (Burleson Family Clinic)
• State of Arkansas
• Abby Staton, PHARM. D
• Stephen Lloyd Stewart, PA-C
• Tommys Rexall Drug Company Inc
• Tracy Family Practice Clinic PA
• Wallace Lee Tracy, M.D.
• Van M Dunn
• Holly Chambless Vansandt, PHARM.D
• Howard Dean Watts, P.D.

• Pharmacist in De Witt, AR
• Providers in De Witt, AR by specialty
• Pharmacist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2017; 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.

Verify at the official NPI Registry.