NPIMap

Organization Active NPI

Medical Center Pharmacy

  • Community/Retail Pharmacy
  • Hampton, IA
National Provider Identifier
1164589123
Registry record updated Jun 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
82 Issued in IA
Legal business name
MEDICAL CENTER PHARMACY
Practice address
1720 Central Ave E
Hampton, IA 50441-1859
Phone
(641) 456-4146
Fax
(641) 456-4984
NPI assigned
Jan 2, 2007
Last updated
Jun 5, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
KOERNER-WHIPPLE PHARMACIES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2015

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

Authorized official

Name
Todd Wragge, PHARM.D.
Title
Pharmacist
Phone
(641) 456-4146

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 82 IA Primary

Addresses

Primary practice location

1720 Central Ave E
Hampton, IA 50441-1859

Mailing address

1720 Central Ave E
Hampton, IA 50441-1859
Phone (641) 456-4146

Other identifiers 2

IdentifierTypeStateIssuer
0263630002OtherIAMEDICARE
0087213MedicaidIA

National Provider Directory

National Provider Directory
Tax ID family
Medical Center Pharmacy2 organizations share this tax ID, including this one
Part of
Medical Center Pharmacy

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433462400000",
    "number": "1164589123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 CENTRAL AVE E",
            "city": "HAMPTON",
            "state": "IA",
            "postal_code": "504411859",
            "telephone_number": "641-456-4146",
            "fax_number": "641-456-4984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 CENTRAL AVE E",
            "city": "HAMPTON",
            "state": "IA",
            "postal_code": "504411859",
            "telephone_number": "641-456-4146",
            "fax_number": "641-456-4984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KOERNER-WHIPPLE PHARMACIES, INC.",
        "enumeration_date": "2007-01-02",
        "last_updated": "2015-06-05",
        "status": "A",
        "authorized_official_last_name": "WRAGGE",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "641-456-4146",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "82",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0263630002",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0087213",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; 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.