NPIMap

Organization Active NPI

Campus Pharmacy IV

  • Pharmacist
  • Reno, NV
National Provider Identifier
1376508705
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
14884 Issued in NV
Legal business name
CAMPUS PHARMACY IV
Practice address
745 West Moana Lane
Suite 100
Reno, NV 89509-4940
Phone
(775) 334-3030
Fax
(775) 334-3039
NPI assigned
Apr 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

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

Authorized official

Name
Mr. Kirk Alan Garland, RPH
Title
Pharmacist Pharmacy Manager
Phone
(775) 334-3030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 14884 NV Primary

Addresses

Primary practice location

745 West Moana Lane
Suite 100
Reno, NV 89509-4940

Mailing address

745 West Moana Lane
Suite 100
Reno, NV 89509-4940
Phone (775) 334-3030

Other identifiers 4

IdentifierTypeStateIssuer
2986668OtherNVNCPDP
3316122MedicaidNV
14884OtherNVPHARMACIST STATE LICENSE
2816122MedicaidNV

National Provider Directory

National Provider Directory
Tax ID family
N F P R P Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1376508705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 WEST MOANA LANE",
            "address_2": "SUITE 100",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895094940",
            "telephone_number": "775-334-3030",
            "fax_number": "775-334-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 WEST MOANA LANE",
            "address_2": "SUITE 100",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895094940",
            "telephone_number": "775-334-3030",
            "fax_number": "775-334-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPUS PHARMACY IV",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "GARLAND",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PHARMACIST PHARMACY MANAGER",
        "authorized_official_telephone_number": "775-334-3030",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "14884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2986668",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3316122",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST STATE LICENSE",
            "identifier": "14884",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2816122",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.