EAST ARKANSAS FAMILY HEALTH CENTER PHARMACY NO. 3, LLC NPI 1922620483

Pharmacy (Community/Retail Pharmacy) in Marvell, AR

NPI 1922620483 Organization Pharmacy Community/Retail Pharmacy CLIA Number 04D2141159 CLIA Certificate of Waiver

NPI Profile for EAST ARKANSAS FAMILY HEALTH CENTER PHARMACY NO. 3, LLC

East Arkansas Family Health Center Pharmacy No. 3, Llc is a provider established in Marvell, Arkansas specializing in pharmacy (community/retail pharmacy) . The NPI number of East Arkansas Family Health Center Pharmacy No. 3, Llc is 1922620483 and was assigned on May 2020. The practitioner's primary taxonomy code is 3336C0003X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Dr. Susan Ward-jones Md (Ceo)

The CLIA number of East Arkansas Family Health Center Pharmacy No. 3, Llc is 04D2141159 registered as a "community clinic" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to East Arkansas Family Health Center Pharmacy No. 3, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1922620483

Provider NameEAST ARKANSAS FAMILY HEALTH CENTER PHARMACY NO. 3, LLC
Provider Location Address406 S MILL ST MARVELL, AR 72366
Provider Mailing Address900 N 7TH ST WEST MEMPHIS, AR 72301
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date05-07-2020
Last Update Date09-01-2020


Primary Taxonomy

Taxonomy Code3336C0003X
ClassificationPharmacy
TypeSuppliers
SpecializationCommunity/Retail Pharmacy
Taxonomy DescriptionA 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.

Business Address

EAST ARKANSAS FAMILY HEALTH CENTER PHARMACY NO. 3, LLC
406 S MILL ST
MARVELL, AR
ZIP 72366
Phone: (870) 829-1168
Fax: (870) 829-1152

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Mailing Address

EAST ARKANSAS FAMILY HEALTH CENTER PHARMACY NO. 3, LLC
900 N 7TH ST
WEST MEMPHIS, AR
ZIP 72301
Phone: (870) 733-6341
Fax: (870) 394-9541



Authorized Official

Authorized Official NameDR. SUSAN WARD-JONES MD
Authorized Official TitleCEO
Authorized Official Phone(870) 735-3842

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1922620483 is:

CLIA Number04D2141159
Facility TypeCOMMUNITY CLINIC
Certificate TypeCertificate of Waiver

NPI Validation Check Digit Calculation


The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1922620483
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
29421220416
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 4 + 2 + 1 + 2 + 2 + 0 + 4 + 1 + 6 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1922620483 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1295752376MARVELL CLINIC PHARMACY, INC.
Organization
Pharmacy406 S MILL ST
MARVEL, AR 72366
(870) 829-1044
1962154005MS. PATRICIA TURNER PD
Individual
Pharmacist406 S MILL ST
MARVELL, AR 72366
(870) 829-9116

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
East Arkansas Family Health Center Pharmacy No. 3, Llc is registered as an entity type code: 2. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.