NPIMap

Organization Active NPI

Hodgeman County Pharmacy LLC

Doing business as Hodgeman County Pharmacy

  • Pharmacy
  • Jetmore, KS
National Provider Identifier
1013460922
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
2-100543 Issued in KS
Legal business name
HODGEMAN COUNTY PHARMACY LLC
Doing business as
Hodgeman County Pharmacy
Practice address
519 Main Street
Jetmore, KS 67854
Phone
(620) 357-8305
Fax
(620) 855-2052
NPI assigned
Jul 27, 2016
Last updated
Oct 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
James CoastNPI 1609969237
Title
RPH
Phone
(620) 855-2055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 2-100543 KS Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

519 Main Street
Jetmore, KS 67854

Mailing address

PO Box 782
Cimarron, KS 67835-0782
Phone (620) 855-2055

Other identifiers 2

IdentifierTypeStateIssuer
2162209OtherPK
201138190AMedicaidKS

Other names 1

  • Hodgeman County Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hodgeman County Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476835200000",
    "number": "1013460922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 782",
            "city": "CIMARRON",
            "state": "KS",
            "postal_code": "678350782",
            "telephone_number": "620-855-2055",
            "fax_number": "620-855-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 MAIN STREET",
            "city": "JETMORE",
            "state": "KS",
            "postal_code": "67854",
            "telephone_number": "620-357-8305",
            "fax_number": "620-855-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HODGEMAN COUNTY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-27",
        "last_updated": "2016-10-19",
        "status": "A",
        "authorized_official_last_name": "COAST",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "RPH",
        "authorized_official_telephone_number": "620-855-2055"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "KS",
            "license": "2-100543",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2162209",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201138190A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hodgeman County Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jetmore, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.