NPIMap

Organization Active NPI

Heritage Park Pharmacy Inc

  • Community/Retail Pharmacy
  • West Burlington, IA
National Provider Identifier
1265276596
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
HERITAGE PARK PHARMACY INC
Practice address
1223 S Gear Ave Ste 105
West Burlington, IA 52655-1690
Phone
(319) 768-3971
NPI assigned
Jun 21, 2024
Last updated
Sep 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Authorized official

Name
Jeremy Alexander
Title
Ceo
Phone
(319) 768-3280

Specialties & licenses 1

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

Addresses

Primary practice location

1223 S Gear Ave Ste 105
West Burlington, IA 52655-1690

Mailing address

1223 S Gear Ave Ste 105
West Burlington, IA 52655-1690
Phone (319) 768-3971

Other practice location 1

1201 W Agency Rd
West Burlington, IA 52655-1660
Phone (319) 753-3681

Other practice location 2

501 S White St Ste 3
Mount Pleasant, IA 52641-2600
Phone (319) 385-6543

Other practice location 3

3032 Avenue L
Fort Madison, IA 52627-3625
Phone (319) 250-9110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250305001352 IA Part B Supplier - Mass Immunization (Roster Biller Only) 9436276102 Practice locations: Fort Madison, IA; Mount Pleasant, IA; West Burlington, IA

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Heritage Park Pharmacy Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

501 S White St
Ste 3
Mt Pleasant, IA 52641
Phone (319) 385-6543

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": "1718928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789516800000",
    "number": "1265276596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 S GEAR AVE STE 105",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551690",
            "telephone_number": "319-768-3971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 S GEAR AVE STE 105",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551690",
            "telephone_number": "319-768-3971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 W Agency Rd",
            "address_purpose": "LOCATION",
            "city": "West Burlington",
            "state": "IA",
            "postal_code": "526551660",
            "country_code": "US",
            "telephone_number": "319-753-3681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 S White St Ste 3",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "IA",
            "postal_code": "526412600",
            "country_code": "US",
            "telephone_number": "319-385-6543",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3032 Avenue L",
            "address_purpose": "LOCATION",
            "city": "Fort Madison",
            "state": "IA",
            "postal_code": "526273625",
            "country_code": "US",
            "telephone_number": "319-250-9110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HERITAGE PARK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-21",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "319-768-3280"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Burlington, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; 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.