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KAVANAUGH PHARMACY
NPI 1093858698
Pharmacy - Community/Retail Pharmacy in Little Rock, AR

Active since February 14, 2007CLIA 04D2157281 · Waiver
5008 KAVANAUGH BLVD, LITTLE ROCK, AR 72207(501) 664-3844 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 7, 2023, Aug 22, 2020 (2 updates tracked since 2020).

About Kavanaugh Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KAVANAUGH PHARMACY (NPI 1093858698) is a healthcare organization registered as a community/retail pharmacy in Little Rock, Arkansas and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through November 1, 2026 and lists Thomas Gregory Cooper, Pharmacist-in-charge, as its authorized official.

NPPES Registry Identity

NPI1093858698
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameKAVANAUGH PHARMACY
Location Address5008 KAVANAUGH BLVDLittle Rock, AR 72207-4747
Mailing Address5008 Kavanaugh BlvdLittle Rock, AR 72207-4747 · (501) 664-3844
Phone(501) 664-3844
Organization SubpartNo
Authorized OfficialThomas Gregory CooperPharmacist-in-charge · (501) 664-3844
Enumeration DateFebruary 14, 2007
Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration
✔ NPI 1093858698 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in AR · AR04183
Definition
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.
5008 KAVANAUGH BLVD, Little Rock, AR 72207
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Other Identifiers 1

Other0404183Ncpdp Number

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 04D2157281

Kavanaugh Pharmacy · Little Rock, AR
Active · expires Nov 1, 2026
CLIA Number04D2157281
Laboratory TypePharmacy
Certificate Effective DateNovember 2, 2024
Certificate Expiration DateNovember 1, 2026
Laboratory DirectorAnne C. Pace
Laboratory Phone(501) 664-3844
Laboratory LocationKavanaugh Pharmacy5200 Kavanaugh Blvd, Little Rock, AR 72207
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KORI RAYMER GORDON
Pharmacist
5008 KAVANAUGH BLVD
LITTLE ROCK, AR 72207
Pulaski County (501) 664-3844

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kavanaugh Pharmacy's NPI number?

The NPI number for Kavanaugh Pharmacy is 1093858698. It was assigned to this organization in the NPPES registry on February 14, 2007.

Where is Kavanaugh Pharmacy located?

Kavanaugh Pharmacy is located at 5008 Kavanaugh Blvd, Little Rock, AR 72207. The listed phone number is (501) 664-3844.

What is Kavanaugh Pharmacy's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Kavanaugh Pharmacy hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D2157281) is associated with this NPI, valid through November 1, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kavanaugh Pharmacy was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.