Mr Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MR PHARMACY LLC

Practice address

560 US Highway 18 E
Clear Lake, IA 50428-1439

Phone

(641) 357-1522

NPI assigned

Jul 9, 2010

Organization subpart

No

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

Authorized official

Name

Rockford Anderson

Title

Pharmd/Owner

Phone

(641) 357-1522

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Clear Lake Pharmacy Doing business as

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315785600000",
    "number": "1134431984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 US HIGHWAY 18 E",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "504281439",
            "telephone_number": "641-357-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 US HIGHWAY 18 E",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "504281439",
            "telephone_number": "641-357-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MR PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-09",
        "last_updated": "2011-09-12",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ROCKFORD",
        "authorized_official_title_or_position": "PHARMD/OWNER",
        "authorized_official_telephone_number": "641-357-1522"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0206234",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clear Lake Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Clear Lake, IA
• Providers in Clear Lake, IA by specialty
• Community/Retail Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; 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.