NPIMap

Organization Active NPI

Haag Apothecary, Inc

  • Community/Retail Pharmacy
  • Emporia, KS
National Provider Identifier
1184057168
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2-12995 Issued in KS
Legal business name
HAAG APOTHECARY, INC
Doing business as
Haag Pharmacy
Practice address
1400 W 12TH Ave Ste a
Emporia, KS 66801-2516
Phone
(620) 342-1242
Fax
(620) 342-1243
NPI assigned
Aug 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Authorized official

Name
Amber N HaagNPI 1619364205
Title
President
Phone
(620) 342-1242

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 2-12995 KS Primary
Compounding Pharmacy 3336C0004X
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

1400 W 12TH Ave Ste a
Emporia, KS 66801-2516

Mailing address

1400 W 12TH Ave
Emporia, KS 66801-2516
Phone (620) 342-1242

Other identifiers 1

IdentifierTypeStateIssuer
2142118OtherPK

Other names 1

  • Haag Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140218000524 KS DME Supplier - Pharmacy 4486883485 Practice locations: Emporia, KS
O20140519002186 KS Part B Supplier - Mass Immunization (Roster Biller Only) 4486883485 Practice locations: Emporia, KS

National Provider Directory

National Provider Directory

Locations

1400 W 12th Ave
Ste A
Emporia, KS 66801
Phone (620) 342-1242

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524528000000",
    "number": "1184057168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 W 12TH AVE",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668012516",
            "telephone_number": "620-342-1242",
            "fax_number": "620-342-1243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W 12TH AVE STE A",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668012516",
            "telephone_number": "620-342-1242",
            "fax_number": "620-342-1243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAAG APOTHECARY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-14",
        "last_updated": "2018-04-24",
        "status": "A",
        "authorized_official_last_name": "HAAG",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "620-342-1242"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KS",
            "license": "2-12995",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142118",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haag Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Haag Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Emporia, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; 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.