Kraege Drug Store

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

00293 Issued in TX

Legal business name

KRAEGE DRUG STORE

Practice address

113 E Main St
Yorktown, TX 78164-2030

Phone

(361) 564-2216

NPI assigned

Jan 16, 2007

Organization subpart

No

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

Authorized official

Name

Thomas Kraege

Title

Partner

Phone

(361) 564-2216

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• THE KRAEGE DRUG STORE Other name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter Dunn

  • Pharmacist
  • Yorktown, TX
  • NPI 1609464478
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480291200000",
    "number": "1053462838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 727",
            "city": "YORKTOWN",
            "state": "TX",
            "postal_code": "781640727",
            "telephone_number": "361-564-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 E MAIN ST",
            "city": "YORKTOWN",
            "state": "TX",
            "postal_code": "781642030",
            "telephone_number": "361-564-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRAEGE DRUG STORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2016-11-28",
        "status": "A",
        "authorized_official_last_name": "KRAEGE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "361-564-2216"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "00293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "4534055",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0185774-01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130669",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE KRAEGE DRUG STORE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Kelly Deanne Hobbs, LPC ASSOCIATE
• Kelly Dean Hranicky, LVN
• Alyce Yvonne Martin, LPC
• Phyllis A Nesbitt, LVN
• Laura Pacek, P.A.
• Maria S Perez Casten
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• Community/Retail Pharmacy in Yorktown, TX
• Providers in Yorktown, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.