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HYDE PHARMACY INC (IMMUNIZATION) NPI 1538597752


NPI Information

NPI: 1538597752
Provider Name: HYDE PHARMACY INC (IMMUNIZATION)
Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 04D2184350

Address:
1001 W KINGSHIGHWAY
PARAGOULD, AR
ZIP 72450
Phone: (870) 239-4036
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HYDE PHARMACY INC (IMMUNIZATION) is a community/retail pharmacy pharmacy in Paragould, AR. The provider is 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. HYDE PHARMACY INC (IMMUNIZATION) NPI is 1538597752. The provider is registered as an organization entity type.

The provider's business location address is:

1001 W KINGSHIGHWAY
PARAGOULD, AR
ZIP 72450-142
Phone: (870) 239-4036
Fax: (870) 239-9478

The provider's authorized official is Kenneth Robert Kuenzel .
The authorized official title is Owner/president and has the following contact phone number (870) 239-4036.

The CLIA number assigned to this NPI record is 04D2184350 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/25/2013 and was last updated on 3/15/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0003XPharmacyCommunity/Retail PharmacyAR16734ARKANSASYes
23336L0003XPharmacyLong Term Care PharmacyAR16734ARKANSASNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1117466407MEDICAIDARKANSAS
2166898716MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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