NPIMap

Organization Active NPI

Carroll Apothecary, Inc

  • Pharmacy
  • Carroll, IA
National Provider Identifier
1073506366
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
357 Issued in IA
Legal business name
CARROLL APOTHECARY, INC
Practice address
425 Highway 30 West
Suite 140
Carroll, IA 51401-0157
Phone
(712) 792-2671
Fax
(712) 792-3601
NPI assigned
Aug 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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

Authorized official

Name
Sharon K Leiting
Title
Vice-President / Business Manager
Phone
(712) 792-2671

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X IA
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X IA
Pharmacy 333600000X 357 IA Primary
Home Infusion Therapy Pharmacy 3336H0001X 357 IA

Addresses

Primary practice location

425 Highway 30 West
Suite 140
Carroll, IA 51401-0157

Mailing address

PO Box 157
Carroll, IA 51401-0157
Phone (712) 792-2671

Other identifiers 3

IdentifierTypeStateIssuer
0101806MedicaidIA
1605205OtherIANABP
IB1631OtherIALOCAL PART B

Other names 1

  • Carroll Apothecary Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100130000155 IA Part B Supplier - Pharmacy 5597844902 Practice locations: Carroll, IA
O20110914000190 IA Part B Supplier - Mass Immunization (Roster Biller Only) 5597844902 Practice locations: Carroll, IA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Carroll Apothecary Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

425 W US Highway 30
Ste 140
Carroll, IA 51401
Phone (712) 792-2671

500 E Valley Dr
Carroll, IA 51401
Phone (712) 792-9281

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340064000000",
    "number": "1073506366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 157",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514010157",
            "telephone_number": "712-792-2671",
            "fax_number": "712-792-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 HIGHWAY 30 WEST",
            "address_2": "SUITE 140",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514010157",
            "telephone_number": "712-792-2671",
            "fax_number": "712-792-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLL APOTHECARY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2012-06-19",
        "status": "A",
        "authorized_official_last_name": "LEITING",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "VICE-PRESIDENT / BUSINESS MANAGER",
        "authorized_official_telephone_number": "712-792-2671"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IA",
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "IA",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IA",
            "license": "357",
            "primary": true
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "IA",
            "license": "357",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0101806",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "1605205",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOCAL PART B",
            "identifier": "IB1631",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carroll Apothecary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carroll, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; 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.