NPIMap

Organization Active NPI

Petes Pharmacy Inc

Doing business as Petes Pharmacy

  • Community/Retail Pharmacy
  • Pawnee City, NE
National Provider Identifier
1174606198
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1425 Issued in NE
Legal business name
PETES PHARMACY INC
Doing business as
Petes Pharmacy
Practice address
643 G St
Pawnee City, NE 68420-0072
Phone
(402) 852-2322
Fax
(402) 852-2928
NPI assigned
Oct 23, 2006
Last updated
Jan 18, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Authorized official

Name
Larry Vonderfecht, BS
Title
Owner
Phone
(402) 852-2321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 1425 NE Primary

Addresses

Primary practice location

643 G St
Pawnee City, NE 68420-0072

Mailing address

PO Box 72
Pawnee City, NE 68420-0072

Other identifiers 1

IdentifierTypeStateIssuer
2053357OtherPK

Other names 1

  • PETES PHARMACY Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1174606198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72",
            "city": "PAWNEE CITY",
            "state": "NE",
            "postal_code": "684200072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "643 G ST",
            "city": "PAWNEE CITY",
            "state": "NE",
            "postal_code": "684200072",
            "telephone_number": "402-852-2322",
            "fax_number": "402-852-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETES PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "VONDERFECHT",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-852-2321",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NE",
            "license": "1425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2053357",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PETES PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pawnee City, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; 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.