Organization Active NPI

Summit View Pharmacy

  • Community/Retail Pharmacy
  • Greeley, CO
National Provider Identifier
1447344080
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
501 Issued in CO
Legal business name
SUMMIT VIEW PHARMACY
Practice address
2001 70TH Ave
Ste 104
Greeley, CO 80634
Phone
(970) 392-2020
Fax
(970) 395-2565
NPI assigned
Oct 3, 2006
Last updated
Jul 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Authorized official

Name
Russell Funk
Title
Ceo, Banner Pharmacy Services
Phone
(602) 747-4197

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 501 CO Primary

Addresses

Primary practice location

2001 70TH Ave
Ste 104
Greeley, CO 80634

Mailing address

2001 70TH Ave
Ste 104
Greeley, CO 80634
Phone (970) 392-2020

Other identifiers 1

IdentifierTypeStateIssuer
10087222MedicaidCO

Other names 1

  • Banner Health Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180731001027 CO Part B Supplier - Pharmacy 8729336219 Practice locations: Greeley, CO

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2001 70th Ave
Ste 104
Greeley, CO 80634
Phone (970) 392-2020

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690502400000",
    "number": "1447344080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 70TH AVE",
            "address_2": "STE 104",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "80634",
            "telephone_number": "970-392-2020",
            "fax_number": "970-395-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 70TH AVE",
            "address_2": "STE 104",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "80634",
            "telephone_number": "970-392-2020",
            "fax_number": "970-395-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT VIEW PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A",
        "authorized_official_last_name": "FUNK",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "CEO, BANNER PHARMACY SERVICES",
        "authorized_official_telephone_number": "602-747-4197"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CO",
            "license": "501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10087222",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Banner Health",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Banner Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.