NPIMap

Organization Active NPI

Heritage Park Pharmacy Inc.

  • Community/Retail Pharmacy
  • West Burlington, IA
National Provider Identifier
1306959531
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
602IA Issued in IA
Legal business name
HERITAGE PARK PHARMACY INC.
Practice address
1223 S. Gear Ave.
Suite 105
West Burlington, IA 52655-1690
Phone
(319) 768-3950
Fax
(319) 768-2955
NPI assigned
Aug 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Authorized official

Name
Michael J McCoy
Title
Ceo
Phone
(319) 768-3268

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 602IA IA Primary

Addresses

Primary practice location

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

Mailing address

1223 S. Gear Ave.
Suite 105
West Burlington, IA 52655-1690
Phone (319) 768-3950

Other identifiers 2

IdentifierTypeStateIssuer
1613365OtherNEPDP
0199695MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930034404 IA DME Supplier - Pharmacy 9436276102 Practice locations: 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

1223 S Gear Ave
Ste 6
West Burlington, IA 52655
Phone (319) 768-3960

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773014400000",
    "number": "1306959531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 S. GEAR AVE.",
            "address_2": "SUITE 105",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551690",
            "telephone_number": "319-768-3950",
            "fax_number": "319-768-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 S. GEAR AVE.",
            "address_2": "SUITE 105",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551690",
            "telephone_number": "319-768-3950",
            "fax_number": "319-768-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE PARK PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "319-768-3268"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "602IA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEPDP",
            "identifier": "1613365",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0199695",
            "state": "IA"
        }
    ],
    "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 Mar 9, 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.