Amicare Pharmacy, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

245 Issued in IA

Legal business name

AMICARE PHARMACY, INC

Practice address

3740 Utica Ridge Rd
Bettendorf, IA 52722-1657

Phone

(563) 344-7450

Fax

(563) 344-7483

NPI assigned

Aug 2, 2006

Organization subpart

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Amicare Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in IA2 enrollments

Enrollment records 2

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

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114934239",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amicare Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Amicare Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Brooke Allen, ARNP
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• Amanda J Alongi, NP
• Alexis Alvarez
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• Amy L Mathis, LLC
• Amy L. Blevins, DC, LLC
• Blake Anderson, ATC
• Crystal Dawn Anderson, LMHC, LCPC
• James Anderson, PHARMD

• All providers in Bettendorf, IA
• Community/Retail Pharmacy in Iowa

• 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.

Verify at the official NPI Registry.