NPIMap

Organization Active NPI

Sun Drug Village Square LTD

  • Community/Retail Pharmacy
  • Johnston, IA
National Provider Identifier
1376619106
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
842 Issued in IA
Legal business name
SUN DRUG VILLAGE SQUARE LTD
Doing business as
Sun Pharmacy
Practice address
6105 Merle Hay Rd
Johnston, IA 50131-1224
Phone
(515) 278-5503
Fax
(515) 254-2242
NPI assigned
Nov 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Steven H Straw, R.PH.
Title
President
Phone
(515) 278-5503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 842 IA Primary

Addresses

Primary practice location

6105 Merle Hay Rd
Johnston, IA 50131-1224

Mailing address

6105 Merle Hay Rd
PO Box 288
Johnston, IA 50131-1224
Phone (515) 278-5503

Other identifiers 2

IdentifierTypeStateIssuer
1613240OtherNCPDP
0197061MedicaidIA

Other names 1

  • Sun Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

6105 Merle Hay Rd
Johnston, IA 50131
Phone (515) 278-5503

Practitioners & affiliated clinicians

Practitioners 2

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": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1376619106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6105 MERLE HAY RD",
            "address_2": "PO BOX 288",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311224",
            "telephone_number": "515-278-5503",
            "fax_number": "515-254-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6105 MERLE HAY RD",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311224",
            "telephone_number": "515-278-5503",
            "fax_number": "515-254-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN DRUG VILLAGE SQUARE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "STRAW",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-278-5503",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1613240",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0197061",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sun Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnston, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.