Organization Active NPI

Stelinhos Beaverdale LLC

  • Community/Retail Pharmacy
  • Des Moines, IA
National Provider Identifier
1457405805
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
STELINHOS BEAVERDALE LLC
Doing business as
MEDICAP PHARMACY
Practice address
2804 Beaver Ave
Des Moines, IA 50310-4038
Phone
(515) 277-3702
Fax
(515) 277-3703
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Lindsey Ludwig, RPH
Title
Owner Pharmacist
Phone
(515) 277-3702

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 1222 IA
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

2804 Beaver Ave
Des Moines, IA 50310-4038

Mailing address

2804 Beaver Ave
Des Moines, IA 50310-4038

Other identifiers 2

IdentifierTypeStateIssuer
1621689OtherOTHER ID NUMBER-COMMERCIAL NUMBER
0418020MedicaidIA

Other names 1

  • MEDICAP PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

2804 Beaver Ave
Des Moines, IA 50310
Phone (515) 277-3702

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1457405805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 BEAVER AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503104038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 BEAVER AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503104038",
            "telephone_number": "515-277-3702",
            "fax_number": "515-277-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STELINHOS BEAVERDALE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "LUDWIG",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "515-277-3702",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IA",
            "license": "1222",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1621689",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0418020",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAP PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.