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:
Map and Directions
Authorized official contact:
Name: Haley, James Zackary PHARMD
Phone: (501) 517-0227

Health care specialties

SpecialtyCodeLicense #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 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013922541 NPPES
Arkansas MEDICAID 027989700
Arkansas MEDICAID 100097407
Arkansas Other 0401745
Arkansas MEDICAID 200054590A

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