Organization Active NPI

Family Pharmacy

  • Pharmacist
  • Maquoketa, IA
National Provider Identifier
1164593398
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
668 Issued in IA
Legal business name
FAMILY PHARMACY
Practice address
805 W Platt St
Maquoketa, IA 52060-2071
Phone
(563) 652-2511
Fax
(563) 652-1874
NPI assigned
Nov 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Dale Richard Yoder, RPH
Title
President
Phone
(563) 652-2511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 668 IA Primary

Addresses

Primary practice location

805 W Platt St
Maquoketa, IA 52060-2071

Mailing address

805 W Platt St
Maquoketa, IA 52060-2071
Phone (563) 652-2511

Other identifiers 1

IdentifierTypeStateIssuer
0079699MedicaidIA

National Provider Directory

National Provider Directory

Locations

805 W Platt St
Maquoketa, IA 52060
Phone (563) 652-2511

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164593398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 W PLATT ST",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602071",
            "telephone_number": "563-652-2511",
            "fax_number": "563-652-1874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W PLATT ST",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602071",
            "telephone_number": "563-652-2511",
            "fax_number": "563-652-1874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YODER",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-652-2511",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0079699",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maquoketa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.