NPIMap

Organization Active NPI

B & R Stores, Inc

Doing business as Super Saver Pharmacy #17

  • Community/Retail Pharmacy
  • Lincoln, NE
National Provider Identifier
1184731499
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2413 Issued in NE
Legal business name
B & R STORES, INC
Doing business as
Super Saver Pharmacy #17
Practice address
2525 Pine Lake Rd
Lincoln, NE 68512-3632
Phone
(402) 420-8268
Fax
(402) 434-5784
NPI assigned
Aug 23, 2006
Last updated
Nov 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Authorized official

Name
Anthony Leo Schmid, PHARMD
Title
Director of Pharmacy
Phone
(402) 464-6297

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 2413 NE Primary

Addresses

Primary practice location

2525 Pine Lake Rd
Lincoln, NE 68512-3632

Mailing address

2525 Pine Lake Rd
Lincoln, NE 68512-3632
Phone (402) 420-8268

Other names 1

  • Super Saver Pharmacy #17 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

Locations

2525 Pine Lake Rd
Lincoln, NE 68512
Phone (402) 420-2094

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352419200000",
    "number": "1184731499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 PINE LAKE RD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685123632",
            "telephone_number": "402-420-8268",
            "fax_number": "402-434-5784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 PINE LAKE RD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685123632",
            "telephone_number": "402-420-8268",
            "fax_number": "402-434-5784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B & R STORES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2012-11-09",
        "status": "A",
        "authorized_official_last_name": "SCHMID",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "LEO",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "402-464-6297",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NE",
            "license": "2413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Super Saver Pharmacy #17",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.