Active NPI
Amicare Pharmacy, Inc
Doing business as Amicare Pharmacy
- Community/Retail Pharmacy
- Bettendorf, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 245
- Legal business name
- AMICARE PHARMACY, INC
- Doing business as
- Amicare Pharmacy
- Practice address
- 3740 Utica Ridge Rd
Bettendorf, IA 52722-1657 - Phone
- (563) 344-7450
- Fax
- (563) 344-7483
- NPI assigned
- Aug 2, 2006
- Last updated
- Aug 5, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Amanda Renee Mull, PHARMD
- Title
- Director of Pharmacy
- Phone
- (563) 505-3528
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 245 | IA | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
3740 Utica Ridge Rd
Bettendorf, IA 52722-1657
Mailing address
3740 Utica Ridge Rd
Bettendorf, IA 52722-1657
Phone (563) 344-7450
Other names 1
- Amicare Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930074480 | IA | DME Supplier - Pharmacy | 8123224169 | Practice locations: Bettendorf, IA |
| O20181031001773 | IA | Part B Supplier - Mass Immunization (Roster Biller Only) | 8123224169 | Practice locations: Bettendorf, IA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D2251182 | Amicare Pharmacy | Certificate of waiver | Jan 31, 2028 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Amicare Pharmacy, Inc. | Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Ostomy Supplies|Urological Supplies|Nebulizer Equipment and/or Supplies | Accepts assignment |
National Provider Directory
National Provider DirectoryLocations
1015 S Hackett Rd
Ste 300
Waterloo, IA 50701
Phone (319) 292-6600
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Pharmacist
- Bettendorf, IA
- NPI 1174556922
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1722816000000",
"number": "1114934239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3740 UTICA RIDGE RD",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527221657",
"telephone_number": "563-344-7450",
"fax_number": "563-344-7483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3740 UTICA RIDGE RD",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527221657",
"telephone_number": "563-344-7450",
"fax_number": "563-344-7483"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMICARE PHARMACY, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-02",
"last_updated": "2024-08-05",
"certification_date": "2024-08-05",
"status": "A",
"authorized_official_last_name": "MULL",
"authorized_official_first_name": "AMANDA",
"authorized_official_middle_name": "RENEE",
"authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
"authorized_official_telephone_number": "563-505-3528",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "IA",
"license": "245",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Amicare Pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Amicare Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Bettendorf, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.