Organization Active NPI

Quier Pharmacy LLC

Doing business as Clearwater Pharmacy

  • Pharmacy
  • Clearwater, KS
National Provider Identifier
1194185512
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
2-13234 Issued in KS
Legal business name
QUIER PHARMACY LLC
Doing business as
Clearwater Pharmacy
Practice address
130 E Ross St Ste 111
Clearwater, KS 67026-7833
Phone
(620) 584-3784
Fax
(620) 886-5517
NPI assigned
Feb 26, 2016
Last updated
Nov 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Authorized official

Name
Nancy Peterson Bradfield
Title
President
Phone
(785) 466-6810

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 2-13234 KS Primary
Community/Retail Pharmacy 3336C0003X NU
Institutional Pharmacy 3336I0012X NU

Addresses

Primary practice location

130 E Ross St Ste 111
Clearwater, KS 67026-7833

Mailing address

PO Box 349
Medicine Lodge, KS 67104-0349
Phone (620) 875-1345

Other identifiers 2

IdentifierTypeStateIssuer
2158321OtherPK
201128690AMedicaidKS

Other names 1

  • Clearwater Pharmacy Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clearwaterpharmacy@hotmail.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200727002693 KS Part B Supplier - Pharmacy 7416382726 Practice locations: Clearwater, KS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D2183948Quier Pharmacy Dba Clearwater Pharmacy130 E Ross Ste 111, Clearwater, KS 67026Certificate of waiverMay 11, 2028

National Provider Directory

National Provider Directory

Locations

130 E Ross St
Ste 111
Clearwater, KS 67026
Phone (620) 584-3784

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1194185512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 349",
            "city": "MEDICINE LODGE",
            "state": "KS",
            "postal_code": "671040349",
            "telephone_number": "620-875-1345",
            "fax_number": "620-886-5517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E ROSS ST STE 111",
            "city": "CLEARWATER",
            "state": "KS",
            "postal_code": "670267833",
            "telephone_number": "620-584-3784",
            "fax_number": "620-886-5517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUIER PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-26",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-15",
        "status": "A",
        "authorized_official_last_name": "BRADFIELD",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "PETERSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "785-466-6810"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "KS",
            "license": "2-13234",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2158321",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201128690A",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clearwaterpharmacy@hotmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "130 E Ross #111",
            "city": "Clearwater",
            "state": "KS",
            "country_code": "US",
            "postal_code": "67026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Clearwater Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clearwater Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clearwater, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.