NPIMap

Organization Active NPI

Heritage Park Pharmacy Inc

  • Community/Retail Pharmacy
  • West Burlington, IA
National Provider Identifier
1487761508
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
625 Issued in IA
Legal business name
HERITAGE PARK PHARMACY INC
Practice address
1201 W Agency Rd
West Burlington, IA 52655-1660
Phone
(319) 753-3284
Fax
(319) 768-3987
NPI assigned
Aug 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Authorized official

Name
Michael J McCoy
Title
Ceo
Phone
(319) 768-3268

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 625 IA Primary

Addresses

Primary practice location

1201 W Agency Rd
West Burlington, IA 52655-1660

Mailing address

1201 W Agency Rd
West Burlington, IA 52655-1660
Phone (319) 753-3681

Other identifiers 2

IdentifierTypeStateIssuer
119965MedicaidIA
2028420OtherPK

Other names 1

  • HERITAGE FAMILY PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930001229 IA DME Supplier - Pharmacy 9436276102 Practice locations: W Burlington, IA

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Heritage Park Pharmacy Inc6 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.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1487761508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W AGENCY RD",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551660",
            "telephone_number": "319-753-3681",
            "fax_number": "319-768-3987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W AGENCY RD",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551660",
            "telephone_number": "319-753-3284",
            "fax_number": "319-768-3987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE PARK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "319-768-3268"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119965",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2028420",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HERITAGE FAMILY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Burlington, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; 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.