Active NPI
Generosa D Archer, PHARMD
- Pharmacist
- Indianola, IA
National Provider Identifier
1013040674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13483
- Practice address
- 404 E Euclid Ave
Indianola, IA 50125-1730 - Phone
- (515) 962-9399
- Fax
- (515) 962-2202
- NPI assigned
- Mar 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 21325 | IA | |
| Pharmacist | 183500000X | 13483 | OK | Primary |
Addresses
Primary practice location
404 E Euclid Ave
Indianola, IA 50125-1730
Mailing address
1209 S 3Rd Street
Indianola, IA 50125
Phone (918) 413-2428
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21325 | IA | MD | Pharmacist |
| 13483 | OK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312156800000",
"number": "1013040674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1209 S 3RD STREET",
"city": "INDIANOLA",
"state": "IA",
"postal_code": "50125",
"telephone_number": "918-413-2428",
"fax_number": "515-962-2202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 E EUCLID AVE",
"city": "INDIANOLA",
"state": "IA",
"postal_code": "501251730",
"telephone_number": "515-962-9399",
"fax_number": "515-962-2202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARCHER",
"first_name": "GENEROSA",
"middle_name": "D",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2011-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "21325",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "13483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianola, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.