GOSNELL DRUGS INC. NPI 1770055923

NPI Information

  • NPI: 1770055923
  • Provider Name: GOSNELL DRUGS INC.
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • CLIA Number: 04D2238294
  • Address: 134 BEVILL AVE
    GOSNELL, AR
    ZIP 72315
  • Phone: (573) 559-5525

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NPI Details

GOSNELL DRUGS INC. is a community/retail pharmacy pharmacy in Gosnell, 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. GOSNELL DRUGS INC. NPI is 1770055923. The provider is registered as an organization entity type.

The provider's business location address is:

134 BEVILL AVE
GOSNELL, AR
ZIP 72315
Phone: (573) 559-5525

The provider's authorized official is Tyson Wallace .
The authorized official title is Owner and has the following contact phone number (870) 751-9242.

The CLIA number assigned to this NPI record is 04D2238294 - 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.

  • Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
  • Fee covid-19 vac 14 res (HCPCS:0134A)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)
  • Fee covid-19 vac 13 res (HCPCS:0124A)
  • Adm sarscov2 30mcg/0.3ml bst (HCPCS:0004A)

The enumeration date for this NPI number is 12/28/2018 and was last updated on 3/19/2021.

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
13336C0003XPharmacyCommunity/Retail PharmacyYes

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
1234926407MEDICAIDARKANSAS
2600073809MEDICAIDMISSOURI

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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