Active NPI
Randy Glen Baldwin, PHARMD
- Pharmacist
- Henderson, NE
National Provider Identifier
1346901949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11169
- Practice address
- 1060 N Main St
Henderson, NE 68371-9798 - Phone
- (402) 723-4475
- Fax
- (402) 723-4476
- NPI assigned
- Jan 5, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11169 | NE | Primary |
Addresses
Primary practice location
1060 N Main St
Henderson, NE 68371-9798
Mailing address
PO Box 711
Henderson, NE 68371-0711
Phone (402) 723-4475
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11169 | NE | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henderson Pharmacy LLC | Pharmacist | Current | Accepting new patients |
| Henderson Pharmacy LLC | Current | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Long Term Care Pharmacy
- Henderson, NE
- NPI 1861220287
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641340800000",
"number": "1346901949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 711",
"city": "HENDERSON",
"state": "NE",
"postal_code": "683710711",
"telephone_number": "402-723-4475",
"fax_number": "402-723-4476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1060 N MAIN ST",
"city": "HENDERSON",
"state": "NE",
"postal_code": "683719798",
"telephone_number": "402-723-4475",
"fax_number": "402-723-4476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALDWIN",
"first_name": "RANDY",
"middle_name": "GLEN",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-01-05",
"last_updated": "2022-01-05",
"certification_date": "2022-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "11169",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.