WHITE RIVER RURAL HEALTH CENTER, INC. (NPI# 1508021619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508021619 |
| Entity Type | Organization |
| Organization Name | WHITE RIVER RURAL HEALTH CENTER, INC. |
| Other Organization Name | COMMUNITY DRUG STORE OF LAKE CITY |
| Practice Address |
1009 Highway 18 Ste B Lake City AR 72437-9622 |
| Mailing Address |
623 N 9th St Augusta AR 72006-2129 |
| Practice Telephone | 8702371246 |
| Practice Fax Number | 8702371248 |
| Mailing Telephone | 8703472534 |
| Mailing Fax Number | 8703472882 |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2008-08-07 |
| Authorized Official Name | STEVE COLLIER (CEO) |
| Authorized Official Telephone | 8703473304 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | WHITE RIVER RURAL HEALTH CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
AR20585 | AR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 0422903 | 01 |
| Other Name | Type Code |
|---|---|
| Community Drug Store of Lake City | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194930941 | White River Rural Health Center, Inc. | Durable Medical Equipment & Medical Supplies | 111 Main Street, Cotton Plant, AR 72036 | 2007-05-14 |
| 1407061237 | White River Rural Health Center, Inc. | Durable Medical Equipment & Medical Supplies | 1740 Church Street, Parkin, AR 72373 | 2007-05-14 |
| Street Address |
1009 HIGHWAY 18 STE B |
| City | LAKE CITY |
| State | AR |
| Zip Code | 72437-9622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801081294 | Arcare | Clinic/Center | 1009 Highway 18, Lake City, AR 72437-9622 | 2007-09-10 |
| 1245522291 | Eye Care of Trumann, Inc | Optometrist | 1009 Highway 18, Ar Care, Lake City, AR 72437-9622 | 2011-05-10 |
| 1013223130 | Jennifer Leeann Long | Nurse Practitioner | 1009 Highway 18, Lake City, AR 72437-9622 | 2010-08-26 |
| 1861654006 | White River Rural Health Center Inc | Clinic/Center | 1009 Highway 18, Lake City, AR 72437-9622 | 2008-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770637126 | Riverside School District | Local Education Agency (LEA) | 601 Catfish Drive, Lake City, AR 72437 | 2007-01-23 |
| 1124274279 | Cynthia A Conner | Speech-Language Pathologist | 2001 Hwy 18, Lake City, AR 72437-0178 | 2008-08-08 |
| 1518953892 | Lakeside Nursing and Rehabilitation Center, Inc. | Skilled Nursing Facility | 1207 Willow Run Road, Lake City, AR 72437-0578 | 2005-09-22 |
| 1447733480 | Chc Lakeside Nursing Center, LLC | Skilled Nursing Facility | 1207 Willow Run St, Lake City, AR 72437-9520 | 2018-09-14 |
| 1083985626 | Kelley Marie Moyer | Specialist/Technologist | 702 Faye St, Lake City, AR 72437-9597 | 2012-01-12 |
| 1396052346 | Southern Health and Wellness, Inc | Pharmacy | 803 Highway 18 Ste B, Lake City, AR 72437-9603 | 2010-09-10 |
| 1639136609 | Kristi Qualls Price | Family Medicine | 803 Highway 18, Lake City, AR 72437-9603 | 2006-04-26 |
| 1124224035 | Jannie L Tackett | Counselor | 208 Cobean Blvd, Lake City, AR 72437-9704 | 2007-06-26 |
| 1811031446 | C.b. Panneck Pharmacies, Inc. | Pharmacist | 210 Cobean Blvd, Suite 10, Lake City, AR 72437-9704 | 2007-02-16 |
| 1912392549 | A Time for Peace Pllc | Counselor | 208 Cobean Blvd, Lake City, AR 72437-9704 | 2015-03-31 |
| Find all providers in zip 72437 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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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| 1922356963 | Piggly Wiggly Lake City Inc | Pharmacy | 269 N Ron Mcnair Blvd, Lake City, SC 29560-2437 | 2012-08-23 |
| 1316958986 | Corner Drug Co Inc | Pharmacy | 414 Main St, Lake City, TN 37769 | 2006-08-10 |
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| 1326674870 | Caraway Drug L.l.c | Pharmacy | 106 W. State Street, Caraway, AR 72419 | 2020-03-17 |
| 1104461532 | Pruett's Food, Inc. | Pharmacy | 101 W. Main, Lockesburg, AR 71846 | 2019-11-08 |
| 1760025274 | Holiday Island Pharmacy, LLC | Pharmacy | 2 Forest Park Dr Ste A, Holiday Island, AR 72631-9229 | 2019-10-28 |
| 1730722463 | Beebe Family Pharmacy, LLC | Pharmacy | 1701 W Dewitt Henry Dr, Beebe, AR 72012-2024 | 2019-10-25 |
| Find all providers with the same taxonomy | ||||
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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.