NPIMap

Organization Active NPI

Ballinger Memorial Hospital District

Doing business as Keel Drug Store

  • Community/Retail Pharmacy
  • Ballinger, TX
National Provider Identifier
1316203573
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28000 Issued in TX
Legal business name
BALLINGER MEMORIAL HOSPITAL DISTRICT
Doing business as
Keel Drug Store
Practice address
2001 Hutchins Ave
Suite a
Ballinger, TX 76821-4452
Phone
(325) 365-3505
Fax
(325) 365-5376
NPI assigned
Apr 2, 2012
Last updated
Oct 26, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Authorized official

Name
Rhett Fricke
Title
Ceo/Administrator
Phone
(325) 365-2531

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 28000 TX Primary

Addresses

Primary practice location

2001 Hutchins Ave
Suite a
Ballinger, TX 76821-4452

Mailing address

PO Box 617
Ballinger, TX 76821-0617
Phone (325) 365-3505

Other identifiers 3

IdentifierTypeStateIssuer
148396MedicaidTX
130089914MedicaidTX
2136290OtherPK

Other names 1

  • Keel Drug Store Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120621000515 TX Part B Supplier - Pharmacy 0042200180 Practice locations: Ballinger, TX
O20130515000077 TX DME Supplier - Pharmacy 0042200180 Practice locations: Ballinger, TX

Other NPIs with the same Medicare PAC ID 7

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

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
Keel Drug Store2001 Hutchins Ave, Ballinger, TX 76821-4453(325) 365-3505 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Nebulizer Equipment and/or Supplies Accepts assignmentParticipating since Sep 16, 2012

National Provider Directory

National Provider Directory
Tax ID family
Ballinger Memorial Hospital7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ballinger Memorial HospitalBallinger, TX, CCN 451310 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 24, 2008
Ballinger Memorial HospitalBallinger, TX, CCN 45Z310 Hospital 5% Or Greater Direct Ownership Interest Jan 1, 1990
Ballinger Healthcare and Rehabilitation CenterBallinger, TX, CCN 675614 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2022
Park Plaza Nursing and Rehabilitation CenterSan Angelo, TX, CCN 675982 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2024
Cedar Manor Nursing and Rehabilitation CenterSan Angelo, TX, CCN 676068 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2024
Ballinger Hospital ClinicBallinger, TX, CCN 458867 Rural health clinic 5% Or Greater Direct Ownership Interest Nov 1, 2005

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603670400000",
    "number": "1316203573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 617",
            "city": "BALLINGER",
            "state": "TX",
            "postal_code": "768210617",
            "telephone_number": "325-365-3505",
            "fax_number": "325-365-5376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 HUTCHINS AVE",
            "address_2": "SUITE A",
            "city": "BALLINGER",
            "state": "TX",
            "postal_code": "768214452",
            "telephone_number": "325-365-3505",
            "fax_number": "325-365-5376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALLINGER MEMORIAL HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-02",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A",
        "authorized_official_last_name": "FRICKE",
        "authorized_official_first_name": "RHETT",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "325-365-2531"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "28000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148396",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130089914",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2136290",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keel Drug Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ballinger, TX

Sources for this page

Verify at the official NPI Registry.