Organization Active NPI

Pottsville Pharmacy Inc

  • Community/Retail Pharmacy
  • Pottsville, AR
National Provider Identifier
1982958484
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
POTTSVILLE PHARMACY INC
Practice address
5395 W Ash St
Suite 9
Pottsville, AR 72858-9170
Phone
(479) 498-4130
Fax
(479) 498-4133
NPI assigned
Nov 5, 2012
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Clinton Bell, PHARM.D.
Title
President
Phone
(479) 498-4130

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130717000729 AR Part B Supplier - Mass Immunization (Roster Biller Only) 0547400418 Practice locations: Pottsville, AR

National Provider Directory

National Provider Directory

Locations

5395 W Ash St
Ste 9
Pottsville, AR 72858
Phone (479) 498-4130

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

NPPES NPI Registry

Primary practice location

5395 W Ash St
Suite 9
Pottsville, AR 72858-9170

Mailing address

PO Box 299
Pottsville, AR 72858-0299
Phone (479) 498-4130

Other names 1

NPPES NPI Registry
  • Pottsville Pharmacy Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 5, 2012.

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352073600000",
    "number": "1982958484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 299",
            "city": "POTTSVILLE",
            "state": "AR",
            "postal_code": "728580299",
            "telephone_number": "479-498-4130",
            "fax_number": "479-498-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5395 W ASH ST",
            "address_2": "SUITE 9",
            "city": "POTTSVILLE",
            "state": "AR",
            "postal_code": "728589170",
            "telephone_number": "479-498-4130",
            "fax_number": "479-498-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTSVILLE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-05",
        "last_updated": "2012-11-05",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-498-4130",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pottsville Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pottsville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; 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.