Organization Active NPI

Southern Health and Wellness, Inc

  • Community/Retail Pharmacy
  • Marked Tree, AR
National Provider Identifier
1992221287
Registry record updated Nov 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
AR04575 Issued in AR
Legal business name
SOUTHERN HEALTH AND WELLNESS, INC
Practice address
203 Newsome Dr Ste a
Marked Tree, AR 72365-2018
Phone
(870) 358-2135
Fax
(870) 358-4055
NPI assigned
Aug 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2025

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

Authorized official

Name
Dr. Kyle Andrew Lomax, PHARM. D.
Title
President
Phone
(870) 275-9496

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X AR04575 AR Primary

Addresses

Primary practice location

203 Newsome Dr Ste a
Marked Tree, AR 72365-2018

Mailing address

3005 Apache Dr
Jonesboro, AR 72401-7432
Phone (870) 275-9496

Other identifiers 2

IdentifierTypeStateIssuer
1992221287OtherNCPDP
AR04575OtherARARKANSAS STATE BOARD OF PHARMACY

Other names 1

  • Southern Pharmacy of Arkansas Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201203002720 AR Part B Supplier - Pharmacy 7810308327 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marked Tree, AR; Lepanto, AR; Jonesboro, AR

Other NPIs on the same Medicare enrollment 4

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2154527Southern Pharmacy of Arkansas203 Newsome Avenue, Suite a, Marked Tree, AR 72365Certificate of waiverSep 13, 2026

National Provider Directory

National Provider Directory
Tax ID family
Monette Discount Drug Inc3 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

203 Newsome Dr
Ste A
Marked Tree, AR 72365
Phone (870) 358-2135

NPI Registry JSON

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761955200000",
    "number": "1992221287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 APACHE DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017432",
            "telephone_number": "870-275-9496",
            "fax_number": "870-455-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 NEWSOME DR STE A",
            "city": "MARKED TREE",
            "state": "AR",
            "postal_code": "723652018",
            "telephone_number": "870-358-2135",
            "fax_number": "870-358-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN HEALTH AND WELLNESS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-17",
        "last_updated": "2025-11-01",
        "certification_date": "2025-11-01",
        "status": "A",
        "authorized_official_last_name": "LOMAX",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-275-9496",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM. D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR04575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1992221287",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS STATE BOARD OF PHARMACY",
            "identifier": "AR04575",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Pharmacy of Arkansas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marked Tree, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.