NPIMap

Organization Active NPI

B & R Stores, Inc

Doing business as Russ's Pharmacy #21

  • Community/Retail Pharmacy
  • Lincoln, NE
National Provider Identifier
1275640203
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2484 Issued in NE
Legal business name
B & R STORES, INC
Doing business as
Russ's Pharmacy #21
Practice address
1550 S Coddington Ave
Lincoln, NE 68522-4402
Phone
(402) 435-8241
Fax
(402) 434-5722
NPI assigned
Aug 24, 2006
Last updated
Nov 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Authorized official

Name
Anthony Leo Schmid, PHARMD
Title
Director of Pharmacy
Phone
(402) 464-6297

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 2484 NE Primary

Addresses

Primary practice location

1550 S Coddington Ave
Lincoln, NE 68522-4402

Mailing address

1550 S Coddington Ave
Lincoln, NE 68522-4402
Phone (402) 435-8241

Other names 1

  • Russ's Pharmacy #21 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930096603 NE DME Supplier - Pharmacy 0143349159 Practice locations: Lincoln, NE
O20110811000480 NE Part B Supplier - Mass Immunization (Roster Biller Only) 0143349159 14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Island, NE; Columbus, NE; Lincoln, NE; Kearney, NE; Hastings, NE

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Russ's Pharmacy #211550 S Coddington Ave, Lincoln, NE 68522-1427(402) 435-8241 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Orthoses: Off-The-Shelf|Ostomy Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies Accepts assignmentParticipating since Aug 1, 2011

National Provider Directory

National Provider Directory
Tax ID family
Super Saver Pharmacy DME12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352419200000",
    "number": "1275640203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 S CODDINGTON AVE",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685224402",
            "telephone_number": "402-435-8241",
            "fax_number": "402-434-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 S CODDINGTON AVE",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685224402",
            "telephone_number": "402-435-8241",
            "fax_number": "402-434-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B & R STORES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2012-11-09",
        "status": "A",
        "authorized_official_last_name": "SCHMID",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "LEO",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "402-464-6297",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NE",
            "license": "2484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Russ's Pharmacy #21",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.