ROSE DRUG OF RUSSELLVILLE, INC
NPI 1952317422
Durable Medical Equipment & Medical Supplies in Russellville, AR

Q: What is Rose Drug Of Russellville, Inc's NPI number?

The NPI number for Rose Drug Of Russellville, Inc is 1952317422. It was assigned to this organization in the NPPES registry on August 1, 2006.

Q: What is Rose Drug Of Russellville, Inc's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Active since August 01, 2006CLIA 04D2184986 · Waiver

3103 W MAIN PL, RUSSELLVILLE, AR 72801(479) 968-1050(479) 968-1557 Get Directions Write a Review

NPPES record last updated: June 12, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 12, 2023, Aug 22, 2020 (2 updates tracked since 2020).

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About Rose Drug Of Russellville, Inc NPPES

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

ROSE DRUG OF RUSSELLVILLE, INC (NPI 1952317422) is a healthcare organization registered as a durable medical equipment & medical supplies in Russellville, Arkansas and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through May 27, 2028 and lists Randy Issa Kassissieh, Owner, as its authorized official.

NPPES Registry Identity

NPI1952317422

Entity TypeOrganization

Primary Taxonomy332B00000X

Legal Business NameROSE DRUG OF RUSSELLVILLE, INC

Location Address3103 W MAIN PLRussellville, AR 72801-3360

Mailing Address3103 W Main PlRussellville, AR 72801-3360 · (479) 968-1050 · Fax (479) 968-1557

Phone(479) 968-1050

Fax(479) 968-1557

Organization SubpartNo

Authorized OfficialRandy Issa KassissiehOwner · (501) 945-3264

Enumeration DateAugust 1, 2006

Last NPPES UpdateJune 12, 20232 updates tracked since enumeration

NPPES CertifiedJune 12, 2023

✔ NPI 1952317422 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers

Taxonomy Code332B00000X

License✔ Licensed in AR · 0413916

Definition

A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

3103 W MAIN PL, Russellville, AR 72801

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Other Identifiers 1

Medicaid110621716AR

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 04D2184986

Rose Drug Of Russellville, Inc · Russellville, AR

Active · expires May 27, 2028

CLIA Number04D2184986

Laboratory TypePharmacy

Certificate Effective DateMay 28, 2026

Certificate Expiration DateMay 27, 2028

Laboratory DirectorMichael D. Smith

Laboratory Phone(479) 968-1050

Laboratory LocationRose Drug Of Russellville, Inc3103 W Main Place, Russellville, AR 72801

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

DR. MEGAN LEANN MOORE PHARM D

Pharmacist