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PPG STORE 6 LLC NPI 1013422179


NPI Information

NPI: 1013422179
Provider Name: PPG STORE 6 LLC

: HEARTLAND PHARMACY CONWAY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 04D2183787

Address:
2235 DAVE WARD DR STE 108
CONWAY, AR
ZIP 72034
Phone: (501) 450-0000
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PPG STORE 6 LLC is a community/retail pharmacy pharmacy in Conway, 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. PPG STORE 6 LLC NPI is 1013422179. The provider is registered as an organization entity type.
The provider Heartland Pharmacy Conway.

The provider's business location address is:

2235 DAVE WARD DR STE 108
CONWAY, AR
ZIP 72034-040
Phone: (501) 450-0000
Fax: (501) 450-6433

The provider's authorized official is Zach Holderfield .
The authorized official title is Partner/ao and has the following contact phone number (870) 814-0605.

The CLIA number assigned to this NPI record is 04D2183787 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/11/2017 and was last updated on 4/18/2018.


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
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail PharmacyAR20873ARKANSASYes

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
12174625OTHERPK

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: 11/14/2023

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