Indian Hills Pharmacy

Primary specialty

PharmacistTaxonomy code 183500000X

License

260 Issued in IA

Legal business name

INDIAN HILLS PHARMACY

Practice address

1551 Indian Hills Dr
Ste 101
Sioux City, IA 51104-1859

Phone

(712) 255-9150

Fax

(712) 255-2946

NPI assigned

Dec 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Wendell Wayne Simmonds, RP

Title

Owner

Phone

(712) 255-9150

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1165104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202169600000",
    "number": "1114095403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 INDIAN HILLS DR",
            "address_2": "STE 101",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511041859",
            "telephone_number": "712-255-9150",
            "fax_number": "712-255-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 INDIAN HILLS DR",
            "address_2": "STE 101",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511041859",
            "telephone_number": "712-255-9150",
            "fax_number": "712-255-2946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN HILLS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-03",
        "last_updated": "2008-02-05",
        "status": "A",
        "authorized_official_last_name": "SIMMONDS",
        "authorized_official_first_name": "WENDELL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-255-9150",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RP"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0142646",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Sioux City, IA
• Providers in Sioux City, IA by specialty
• Pharmacist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.