NPIMap

Organization Active NPI

Iowa Specialty Hospital - Clarion

Doing business as Iowa Specialty Pharmacy

  • Community/Retail Pharmacy
  • Clarion, IA
National Provider Identifier
1386719748
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
362 Issued in IA
Legal business name
IOWA SPECIALTY HOSPITAL - CLARION
Doing business as
Iowa Specialty Pharmacy
Practice address
215 13TH Ave SW
Clarion, IA 50525-2078
Phone
(515) 532-2801
Fax
(515) 532-9321
NPI assigned
Nov 21, 2006
Last updated
Jun 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Authorized official

Name
Steve Siminon
Title
Ceo
Phone
(515) 532-9333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 362 IA Primary

Addresses

Primary practice location

215 13TH Ave SW
Clarion, IA 50525-2078

Mailing address

215 13TH Ave SW
Clarion, IA 50525-2078
Phone (515) 532-2801

Other identifiers 2

IdentifierTypeStateIssuer
0381980001OtherIAPTAN
0170126MedicaidIA

Other names 1

  • Iowa Specialty Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930051695 IA DME Supplier - PharmacyDME Supplier - Hospital 3375451347 Practice locations: Clarion, IA

Other NPIs with the same Medicare PAC ID 5

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
Community Pharmacy215 13TH Ave SW, Clarion, IA 50525-2078(515) 532-2801 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jan 1, 1992

National Provider Directory

National Provider Directory
Tax ID family
Iowa Specialty Hospital- Clarion22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

215 13th Ave SW
Clarion, IA 50525
Phone (515) 532-2836

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Iowa Specialty Hospital- ClarionClarion, IA, CCN 161302 Hospital Operational/Managerial Control (100%) Jan 1, 2000
Iowa Specialty Hospital-ClarionClarion, IA, CCN 16Z302 Hospital Operational/Managerial Control (100%) Jan 1, 2000
Fort Dodge ClinicFort Dodge, IA, CCN 168644 Rural health clinic Operational/Managerial Control (100%) Jan 1, 2000

Owned or controlled facilities with NPI records 3

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": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1386719748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 13TH AVE SW",
            "city": "CLARION",
            "state": "IA",
            "postal_code": "505252078",
            "telephone_number": "515-532-2801",
            "fax_number": "515-532-9321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 13TH AVE SW",
            "city": "CLARION",
            "state": "IA",
            "postal_code": "505252078",
            "telephone_number": "515-532-2801",
            "fax_number": "515-532-9321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA SPECIALTY HOSPITAL - CLARION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "SIMINON",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-532-9333"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "0381980001",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0170126",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Iowa Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Iowa Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarion, IA

Sources for this page

Verify at the official NPI Registry.