Des Moines Central Correctional Pharmacy

Primary specialty

Institutional PharmacyTaxonomy code 3336I0012X

License

1456 Issued in IA

Legal business name

DES MOINES CENTRAL CORRECTIONAL PHARMACY

Practice address

250 Elm Ave SW
Mitchellville, IA 50169-9610

Phone

(515) 725-5065

Fax

(515) 725-5070

NPI assigned

Mar 30, 2018

Organization subpart

No

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

Authorized official

Name

Kathy Lee

Title

Pharmacy Supervisor

Phone

(515) 725-5065

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Des Moines Central Correctional Pharmacy Doing business as

Locations

Practitioners 1

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

• Susan Margaret Shields, RPH

  • Pharmacist
  • Mitchellville, IA
  • NPI 1891713426
  NPD (past)

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522368000000",
    "number": "1235635285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 ELM AVE SW",
            "city": "MITCHELLVILLE",
            "state": "IA",
            "postal_code": "501699610",
            "telephone_number": "515-725-5065",
            "fax_number": "515-725-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 ELM AVE SW",
            "city": "MITCHELLVILLE",
            "state": "IA",
            "postal_code": "501699610",
            "telephone_number": "515-725-5065",
            "fax_number": "515-725-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DES MOINES CENTRAL CORRECTIONAL PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-30",
        "last_updated": "2018-03-30",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "PHARMACY SUPERVISOR",
        "authorized_official_telephone_number": "515-725-5065"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "IA",
            "license": "1456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176604",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Des Moines Central Correctional Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John W. Anderson
• Blue Care Opco Mitchellville, LLC
• City of Mitchellville
• Steven Michael Cook, M.D.
• Jered Flinkman, FPMHNP
• Cherlyn Anne Gingras
• Heather Lynn Horton
• Kadel Medical Services, LLC
• Timothy Kadel

• Institutional Pharmacy in Mitchellville, IA
• Providers in Mitchellville, IA by specialty
• Institutional Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; 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.