TOMMYS REXALL DRUG COMPANY INC. (NPI# 1962553404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962553404 |
| Entity Type | Organization |
| Organization Name | TOMMYS REXALL DRUG COMPANY INC. |
| Practice Address |
220 Court Sq Dewitt AR 72042-2057 |
| Practice Telephone | 8709464221 |
| Practice Fax Number | 8709461181 |
| Mailing Telephone | 8709464221 |
| Mailing Fax Number | 8709461181 |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2017-09-01 |
| Authorized Official Name | MR. TOMMY GLENN BLACK (PHARMACIST) |
| Authorized Official Telephone | 8709464221 |
| Authorized Official Credential | P.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 183500000X | Pharmacist | AR14071 | AR | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 100643407 | 05 | |
| AR | 120942716 | 05 |
| Street Address |
220 COURT SQ |
| City | DEWITT |
| State | AR |
| Zip Code | 72042-2057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295839397 | Stanley Wayne Burleson | Family Medicine | 705 W 16th St, Dewitt, AR 72042 | 2006-09-11 |
| 1770796401 | Randall S Hestir Dds Inc | Dentist | 1703 S Whitehead Dr, Dewitt, AR 72042 | 2007-05-08 |
| 1013076397 | James Douglas Allen | Dentist | 1703 S Whitehead Dr, Dewitt, AR 72042 | 2006-12-06 |
| 1780754036 | Randall S Hestir | Dentist | 1703 S Whitehead Dr, Dewitt, AR 72042 | 2006-11-08 |
| 1710207808 | Suzette Nicole Boyd | Nurse Practitioner | 1641 South Whitehead Drive, Dewitt, AR 72042-0000 | 2010-06-11 |
| 1992714992 | Evergreene Properties of North Carolina,llc | Skilled Nursing Facility | 1325 Liberty Drive, Dewitt, AR 72042-0589 | 2006-08-07 |
| 1225328511 | Dewitt School District | Local Education Agency (LEA) | 422 W 1st St, De Witt, AR 72042-1906 | 2011-04-08 |
| 1629376173 | Tiffany N Mcpherson | Counselor | 108 S Jefferson St, De Witt, AR 72042-1929 | 2011-03-08 |
| 1376793406 | Dana's House, Inc. | Foster Care Agency | 108 S Jefferson St, De Witt, AR 72042-1929 | 2008-09-25 |
| 1164550760 | Markallen Behavioral Health System, Inc. | Counselor | 108 S Jefferson St, Dewitt, AR 72042-1929 | 2007-03-02 |
| Find all providers in zip 72042 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164070660 | Safa Abugroun | Pharmacist | 13020 Old Us 27, Dewitt, MI 48820 | 2019-08-28 |
| 1295158566 | Michael Murphy | Pharmacist | 12821 Cross Over Dr, Dewitt, MI 48820-7993 | 2014-01-22 |
| 1275787335 | Gregory S Bovee | Pharmacist | 4250 W Cutler Rd, Healthy Lifestyles, LLC., Dewitt, MI 48820-8080 | 2008-11-15 |
| 1114184256 | Trupti B Patel | Pharmacist | 13157 1/2 Schavey Rd, Dewitt, MI 48820-9016 | 2008-05-16 |
| 1639375934 | Dana K Luebke | Pharmacist | 3512 Highway 17, Dewitt, AR 72042-3633 | 2007-06-23 |
| 1992910483 | Heide Ann Novack | Pharmacist | 13157 1/2 Schavey, Dewitt, MI 48820 | 2007-05-10 |
| 1740406370 | Sara B Peters | Pharmacist | 6750 S Loomis Rd, Dewitt, MI 48820-9753 | 2007-04-18 |
| 1003942616 | Vaughn V Hafner | Pharmacist | 13157 Schavey Rd, Dewitt, MI 48820-9016 | 2007-02-26 |
| 1659391753 | Elizabeth A Howe | Pharmacist | 12950 S Us Highway 27, Dewitt, MI 48820-7956 | 2006-07-20 |
| 1831116573 | Holly Chambless Vansandt | Pharmacist | 1626 S Madison St, Dewitt, AR 72042-3003 | 2006-07-17 |
| Find all providers in DEWITT | ||||
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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.