Chartwell Pharmacy LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

CHARTWELL PHARMACY LLC

Practice address

608 13TH Ave Ste 101
Council Bluffs, IA 51501-6401

Phone

(712) 314-2303

Fax

(712) 224-4043

NPI assigned

Feb 27, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Douglas Robert Russell, RPH

Title

Owner / Managing Partner

Phone

(502) 817-8620

Specialties & licenses 1

Addresses

Other names 1

• Serviam Pharmacy of Council Bluffs Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677456000000",
    "number": "1154020402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 13TH AVE STE 101",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515016401",
            "telephone_number": "712-314-2303",
            "fax_number": "712-224-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 13TH AVE STE 101",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515016401",
            "telephone_number": "712-314-2303",
            "fax_number": "712-224-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARTWELL PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-25",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER / MANAGING PARTNER",
        "authorized_official_telephone_number": "502-817-8620",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serviam Pharmacy of Council Bluffs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gilbert John Cerveny, LMHC
• Alison Marie Chab
• Donella Raye Chadwick-Kermeen, APRN
• Ann Chambers, RDH
• Chapters Council Bluffs Opco LLC
• Emily Chavez, NP
• Yuttana Chawengsub, M.D., PH.D.
• Kyle M Cheatham, O. D.
• Thomas Francis Cheatle, MD
• Michael Chen, DO

• Long Term Care Pharmacy in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Long Term Care Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.