Organization Active NPI

Choice City Drug, Inc

Doing business as city drug

  • Durable Medical Equipment & Medical Supplies
  • Fort Collins, CO
National Provider Identifier
1093727083
Registry record updated Aug 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
440000004 Issued in CO
Legal business name
CHOICE CITY DRUG, INC
Doing business as
city drug
Practice address
209 S College Ave
Fort Collins, CO 80524-2808
Phone
(970) 482-1234
Fax
(970) 482-1098
NPI assigned
Aug 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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

Authorized official

Name
Bernhard C Wilkins, BSCHEM,BSPHARM,BOC,NPI 1942206685
Title
Ceo
Phone
(970) 482-1234

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 440000004 CO Primary
Customized Equipment (DME) 332BC3200X 440000004 CO
Nursing Facility Supplies (DME) 332BN1400X 440000004 CO
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 440000004 CO
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

209 S College Ave
Fort Collins, CO 80524-2808

Mailing address

209 N College Ave
Fort Collins, CO 80524-2808
Phone (970) 482-1234

Other identifiers 2

IdentifierTypeStateIssuer
0611776OtherCONABP
03001328MedicaidCO

Other names 1

  • city drug Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930063500 CO DME Supplier - PharmacyDME Supplier - Orthotic PersonnelDME Supplier - Oxygen & EquipmentDME Supplier - Prosthetic Personnel 4981621299 Practice locations: Fort Collins, CO
O20121228000287 CO Part B Supplier - Mass Immunization (Roster Biller Only) 4981621299 Practice locations: Fort Collins, CO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
City Drug209 N College Ave, Fort Collins, CO 80524-2404(970) 482-1234 Epoetin|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|Pneumatic Compression Devices and/or Supplies|Traction Equipment|Canes and/or Crut… Does not accept assignmentParticipating since Nov 1, 1991

National Provider Directory

National Provider Directory

Locations

101 S College Ave
Fort Collins, CO 80524
Phone (970) 482-1234

209 N College Ave
Fort Collins, CO 80524
Phone (970) 412-6506

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": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596758400000",
    "number": "1093727083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 N COLLEGE AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805242808",
            "telephone_number": "970-482-1234",
            "fax_number": "970-482-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 S COLLEGE AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805242808",
            "telephone_number": "970-482-1234",
            "fax_number": "970-482-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOICE CITY DRUG, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A",
        "authorized_official_last_name": "WILKINS",
        "authorized_official_first_name": "BERNHARD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-482-1234",
        "authorized_official_credential": "BSCHEM,BSPHARM,BOC,"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CO",
            "license": "440000004",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CO",
            "license": "440000004",
            "primary": false
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "CO",
            "license": "440000004",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "CO",
            "license": "440000004",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "0611776",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03001328",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "city drug",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "city drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.