Organization Active NPI

Health Professional Resources Inc

Doing business as Community Pharmacy

  • Pharmacy
  • Logansport, IN
National Provider Identifier
1275513707
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
60004263B Issued in IN
Legal business name
HEALTH PROFESSIONAL RESOURCES INC
Doing business as
Community Pharmacy
Practice address
1201 Michigan Ave
Ste 100
Logansport, IN 46947-1580
Phone
(574) 732-0418
Fax
(574) 753-8549
NPI assigned
Jan 19, 2006
Last updated
Apr 18, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Authorized official

Name
Angela BowenNPI 1023957933
Title
Pharmacist in Charge
Phone
(574) 732-0418

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 60004263B IN Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

1201 Michigan Ave
Ste 100
Logansport, IN 46947-1580

Mailing address

1201 Michigan Ave
Ste 100
Logansport, IN 46947-1580
Phone (574) 732-0418

Other identifiers 2

IdentifierTypeStateIssuer
100294260AMedicaidIN
2027371OtherPK

Other names 1

  • COMMUNITY PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240403002883 IN Part B Supplier - Pharmacy 2668411976 Practice locations: Logansport, IN

National Provider Directory

National Provider Directory

Locations

1201 Michigan Ave
Ste 100
Logansport, IN 46947
Phone (574) 732-0418

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": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492473600000",
    "number": "1275513707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 MICHIGAN AVE",
            "address_2": "STE 100",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471580",
            "telephone_number": "574-732-0418",
            "fax_number": "574-753-8549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 MICHIGAN AVE",
            "address_2": "STE 100",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471580",
            "telephone_number": "574-732-0418",
            "fax_number": "574-753-8549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH PROFESSIONAL RESOURCES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2017-04-18",
        "status": "A",
        "authorized_official_last_name": "BOWEN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "574-732-0418"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IN",
            "license": "60004263B",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100294260A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2027371",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMUNITY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Logansport, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.