MARA GEORGE (NPI# 1962040550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962040550 |
| Entity Type | Individual |
| Full Name | MARA GEORGE |
| Practice Address |
103 Gregory Pl Jacksonville AR 72076-3211 |
| Mailing Address |
315 N Spruce St Little Rock AR 72205-3838 |
| Practice Telephone | 5019850822 |
| Practice Fax Number | 5019853610 |
| Mailing Telephone | 4794626165 |
| Enumeration Date | 2019-12-15 |
| Last Update Date | 2020-02-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
PD12760 | AR | Pharmacy Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 315 N Spruce St, Little Rock, AR 722053838 | 4794626165 |
| Street Address |
103 GREGORY PL |
| City | JACKSONVILLE |
| State | AR |
| Zip Code | 72076-3211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598799348 | Kroger Limited Partnership I | Pharmacy | 103 Gregory Pl, Jacksonville, AR 72076-3211 | 2006-07-10 |
| 1285272492 | Tristan Phillips | Pharmacist | 103 Gregory Pl, Jacksonville, AR 72076-3211 | 2019-12-18 |
| 1396383865 | Roderick Romes Jr. | Pharmacist | 103 Gregory Pl, Jacksonville, AR 72076-3211 | 2019-12-16 |
| 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 | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912343492 | Alyson Gibson Wilder | Pharmacist | 13925 Fish Eagle Dr E, Jacksonville, FL 32226-5894 | 2013-05-10 |
| 1235368473 | Dione Kisha Washington | Pharmacist | 10137 Lancashire Dr, Jacksonville, FL 32219-4367 | 2009-07-09 |
| 1659986529 | Henry Lee Simmons Jr. | Pharmacist | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-09-09 |
| 1356954911 | Haleigh Diane Shelton | Pharmacist | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-08-24 |
| 1649880097 | Meseret Tilahun Dabi | Pharmacist | 655 W 8th St # C-89, Jacksonville, FL 32209-6511 | 2020-07-31 |
| 1699326223 | Mariya Kotova | Pharmacist | 655 W 8th St, Jacksonville, FL 32209-6511 | 2019-09-25 |
| 1386099406 | Tracy Nicole Coker Durrett | Pharmacist | 655 W 8th St, Jacksonville, FL 32209-6511 | 2016-04-26 |
| 1831527878 | Lori Serrano Fiallo | Pharmacist | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2013-10-30 |
| 1588005680 | Lindsey Shea Tate | Pharmacist | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2013-07-17 |
| 1134563851 | Laura Benedict | Pharmacist | 655 West 8th Street, Shands Jacksonville Department of Pharmacy, Jacksonville, FL 32209 | 2013-04-24 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 72076 |
Please comment or provide details below to improve the information on MARA GEORGE.
| 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.