NPIMap

Organization Active NPI

B & R Stores Inc

Doing business as Haeberle's Grand Central Pharmacy

  • Community/Retail Pharmacy
  • Kearney, NE
National Provider Identifier
1184650814
Registry record updated Nov 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2846 Issued in NE
Legal business name
B & R STORES INC
Doing business as
Haeberle's Grand Central Pharmacy
Practice address
7 W 25TH St
Kearney, NE 68847-4432
Phone
(308) 237-2545
Fax
(308) 234-3093
NPI assigned
Jun 24, 2006
Last updated
Nov 26, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2014

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

Authorized official

Name
Anthony Schmid
Title
Pharmacy Director
Phone
(402) 464-6297

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 2846 NE Primary

Addresses

Primary practice location

7 W 25TH St
Kearney, NE 68847-4432

Mailing address

7 W 25TH St
Kearney, NE 68847-4432
Phone (308) 237-2545

Other identifiers 2

IdentifierTypeStateIssuer
47072894000MedicaidNE
2120861OtherPK

Other names 1

  • Haeberle's Grand Central Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110811000480 NE Part B Supplier - Mass Immunization (Roster Biller Only) 0143349159 14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Island, NE; Columbus, NE; Lincoln, NE; Kearney, NE; Hastings, NE

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416960000000",
    "number": "1184650814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 W 25TH ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688474432",
            "telephone_number": "308-237-2545",
            "fax_number": "308-234-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 W 25TH ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688474432",
            "telephone_number": "308-237-2545",
            "fax_number": "308-234-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B & R STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2014-11-26",
        "status": "A",
        "authorized_official_last_name": "SCHMID",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "402-464-6297"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NE",
            "license": "2846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47072894000",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2120861",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haeberle's Grand Central Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; 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.