Nyberg Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

004441 Issued in MO

Legal business name

NYBERG PHARMACY INC

Doing business as

Nyberg Pharmacy

Practice address

315 S Ash
Buffalo, MO 65622-0860

Phone

(417) 345-2321

Fax

(417) 345-8837

NPI assigned

Aug 18, 2006

Last updated

Jan 27, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dwight Nyberg, RPHNPI 1013144377

Title

Owner/Pic

Phone

(417) 345-2321

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• NYBERG 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, and the practitioner matching its NPPES authorized official.

• Dwight K Nyberg Jr., R.PH.

  • Pharmacist
  • Buffalo, MO
  • NPI 1013144377
  NPD (past) Authorized official

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327622400000",
    "number": "1245344217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860",
            "city": "BUFFALO",
            "state": "MO",
            "postal_code": "656220860",
            "telephone_number": "417-345-2321",
            "fax_number": "417-345-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S ASH",
            "city": "BUFFALO",
            "state": "MO",
            "postal_code": "656220860",
            "telephone_number": "417-345-2321",
            "fax_number": "417-345-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYBERG PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2012-01-27",
        "status": "A",
        "authorized_official_last_name": "NYBERG",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_title_or_position": "OWNER/PIC",
        "authorized_official_telephone_number": "417-345-2321",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "004441",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600053904",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2605129",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NYBERG PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Toni R McGinnis, NP
• Mercy Clinic Springfield Communities (Mercy Clinic Family Medicine-Buffalo)
• Mercy Hospital Lebanon (Mercy Clinic Buffalo)
• Rex A Newcomb, O.D.
• Stephanie L Nimmo, NP
• Alvin Nyberg, RPH
• Dwight K Nyberg Jr., R.PH.
• David H Paul, DDS
• Sheri L Pearlstein, M.S.
• Taylor Nicole Pedersen, DO

• Community/Retail Pharmacy in Buffalo, MO
• Providers in Buffalo, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; 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.