HERITAGE SENIOR CARE LLC (NPI# 1154704062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154704062 |
| Entity Type | Organization |
| Organization Name | HERITAGE SENIOR CARE LLC |
| Other Organization Name | HERITAGE SENIOR CARE |
| Practice Address |
607 W Main St Ste B Jacksonville AR 72076-4431 |
| Practice Telephone | 5014750396 |
| Practice Fax Number | 5014750398 |
| Mailing Telephone | 5014750396 |
| Mailing Fax Number | 5014750398 |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2015-07-16 |
| Authorized Official Name | MARK MCMURRY (OWNER) |
| Authorized Official Telephone | 5016504709 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2153063 | 01 |
| Other Name | Type Code |
|---|---|
| Heritage Senior Care | Doing Business As Name - Organization |
| Street Address |
607 W MAIN ST STE B |
| City | JACKSONVILLE |
| State | AR |
| Zip Code | 72076-4431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598396046 | Jennifer Michelle Price | Licensed Practical Nurse | 2400 West Main, Jacksonville, AR 72076 | 2020-02-03 |
| 1912464009 | Stat Home Health - Cenark LLC | Home Health | 1410 Braden Street, Jacksonville, AR 72076 | 2019-02-25 |
| 1649797671 | Caring Hearts Counseling, LLC | Case Management | 111 Marble Drive, Jacksonville, AR 72076 | 2017-08-30 |
| 1376071340 | Anne Elizabeth Houtchens | Speech-Language Pathologist | 2701 Tp White Drive, Jacksonville, AR 72076 | 2017-06-02 |
| 1881140648 | Jacksonville North Pulaski School District | Local Education Agency (LEA) | 1414 West Main, Jacksonville, AR 72076 | 2016-08-31 |
| 1134599772 | Jeremiah Melson Fleeman | Occupational Therapist | 2701 Tpwhite Drive, Jacksonville, AR 72076 | 2015-09-25 |
| 1821424565 | Kasey Michele Leeson | Social Worker | 2520 W. Main St., Jacksonville, AR 72076 | 2013-09-25 |
| 1407104052 | Cesalie Deonne Wallace | Nurse Practitioner | 3000 North First Street, Jacksonville, AR 72076 | 2012-08-29 |
| 1952660995 | Joshua Aaron Hill | Case Manager/Care Coordinator | 2126 N. 1st St Suite F, Jacksonville, AR 72076 | 2012-05-11 |
| 1396023156 | Syreeta Tucker | Case Manager/Care Coordinator | 1109 Burman, Jacksonville, AR 72076 | 2011-07-28 |
| Find all providers in zip 72076 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| 1154962371 | Jai Maruti Rx LLC | Pharmacy | 9323 Lem Turner Rd, Jacksonville, FL 32208-2274 | 2019-09-30 |
| 1669930467 | Av Pharma LLC | Pharmacy | 1545 University Blvd N, Jacksonville, FL 32211-5229 | 2019-03-11 |
| 1801354832 | Pich Ktm Corp | Pharmacy | 13770 Beach Blvd Ste 3, Jacksonville, FL 32224-7227 | 2019-03-08 |
| 1629495536 | Guardian Pharmacy of Jacksonville, LLC | Pharmacy | 8000 Belfort Pkwy, Suite 200, Jacksonville, FL 32256-6934 | 2014-03-28 |
| 1033154232 | Omnicare Pharmacy of Florida, LLC | Pharmacy | 9143 Philips Hwy, #533, Jacksonville, FL 32256-1348 | 2006-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841841715 | Village Apothecary Inc | Pharmacy | 24615 Highway 5, Lonsdale, AR 72087-8017 | 2019-09-23 |
| 1104484971 | Austin Gilbreath | Pharmacy | 970d Ash Flat Dr, Ash Flat, AR 72513-9533 | 2019-06-05 |
| 1295291441 | Health Depot Pharmacies, LLC | Pharmacy | 1610 Fort St, Barling, AR 72923-2018 | 2019-02-13 |
| 1417458829 | Paragon Pharmacy, LLC | Pharmacy | 14524 Cantrell Rd Ste 100a, Little Rock, AR 72223-4700 | 2018-02-22 |
| 1619326881 | Wagner Drugs, Inc. | Pharmacy | 744 Hwy 270 East, Mount Ida, AR 71957 | 2016-06-08 |
| 1669826954 | Caeb Investments Inc. | Pharmacy | 11200 Arch Street, Little Rock, AR 72206 | 2016-04-22 |
| 1215349667 | Midsouth Medical Specialties, LLC | Pharmacy | 5500 Central Avenue, Hot Springs, AR 71913 | 2014-05-20 |
| 1942645569 | Warmack Pharmacies,inc. | Pharmacy | 300 Pine Street, Rison, AR 71665 | 2013-05-09 |
| 1588972418 | Allied Health Services LLC | Pharmacy | 600 N Main St Ste C, Melbourne, AR 72556-0769 | 2010-09-14 |
| 1457565400 | Professional Pharmacy | Pharmacy | 1515 N. Medical Drive, Stuttgart, AR 72160 | 2007-05-09 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 72076 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.