PPG STORE 6 LLC NPI 1013422179

NPI Information

  • NPI: 1013422179
  • Provider Name: PPG STORE 6 LLC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • : HEARTLAND PHARMACY CONWAY
  • CLIA Number: 04D2183787
  • Address: 2235 DAVE WARD DR STE 108
    CONWAY, AR
    ZIP 72034
  • Phone: (501) 450-0000

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NPI Details

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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
  • Fee covid-19 vac 14 res (HCPCS:0134A)
  • Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage (HCPCS:90686)
  • Fee covid-19 vac 13 res (HCPCS:0124A)
  • Adm sarscov2 100mcg/0.5ml3rd (HCPCS:0013A)

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other 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: 3/30/2025

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