NPIMap

Organization Active NPI

Gbank Health LLC

  • Community/Retail Pharmacy
  • North Liberty, IA
National Provider Identifier
1447355433
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
402 Issued in IA
Legal business name
GBANK HEALTH LLC
Practice address
555 W Cherry St
North Liberty, IA 52317-9797
Phone
(319) 626-6188
Fax
(319) 626-6195
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Authorized official

Name
Amanda Renee Mull, PHARMD
Title
Director of Pharmacy Operations
Phone
(563) 505-3528

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 402 IA
Community/Retail Pharmacy 3336C0003X 402 IA Primary

Addresses

Primary practice location

555 W Cherry St
North Liberty, IA 52317-9797

Mailing address

555 W Cherry St
North Liberty, IA 52317-9797
Phone (319) 626-6188

Other identifiers 1

IdentifierTypeStateIssuer
1447355433MedicaidIA

Other names 1

  • North Liberty Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190102001750 IA Part B Supplier - Mass Immunization (Roster Biller Only) 9133464654 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Amana, IA; Bettendorf, IA; Cedar Rapids, IA; Mount Vernon, IA; North Liberty, IA; Tipton, IA
O20190301000718 IA DME Supplier - Pharmacy 9133464654 Practice locations: North Liberty, IA

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Gbank Health LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

876 Tanglefoot Ln
Bettendorf, IA 52722
Phone (563) 345-6546

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1447355433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W CHERRY ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523179797",
            "telephone_number": "319-626-6188",
            "fax_number": "319-626-6195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W CHERRY ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523179797",
            "telephone_number": "319-626-6188",
            "fax_number": "319-626-6195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GBANK HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "MULL",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY OPERATIONS",
        "authorized_official_telephone_number": "563-505-3528",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IA",
            "license": "402",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447355433",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Liberty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Liberty, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.