West Side Pharmacy
LBN: West Side Pharmacy Incorporated
West Side Pharmacy is an health care organization with primary practice located at 620 West South Street , Benton AR 72015. The organization recently has 5 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Medical Specialty, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
West Side Pharmacy Incorporated can be contacted via phone (501) 778-3151, or through Haley, James Zackary via phone (501) 517-0227.
Contact Information
Primary practice address
620 West South Street
Benton AR 72015
Phone: (501) 778-3151
Fax: (501) 778-7329
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Medical Specialty | 261QM2500X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | AR01745 | Arkansas |
| Suppliers / Compounding Pharmacy | 3336C0004X | ||
| Suppliers / Long Term Care Pharmacy | 3336L0003X |
Profile Details
| NPI number | 1013922541 |
|---|---|
| LBN Legal business name | West Side Pharmacy Incorporated |
| DBA Doing business as | West Side Pharmacy |
| Authorized official | Haley, James Zackary PHARMD |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 31st, 2006 |
| Last updated | Dec 14th, 2020 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013922541 | NPPES |
| Arkansas | MEDICAID | 027989700 | |
| Arkansas | MEDICAID | 100097407 | |
| Arkansas | Other | 0401745 | |
| Arkansas | MEDICAID | 200054590A |
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