Spamm LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SPAMM LLC

Doing business as

Medicine Man Pharmacy

Practice address

122 W 16TH St
Schuyler, NE 68661-1668

Phone

(402) 352-3020

NPI assigned

Feb 8, 2019

Last updated

Jun 8, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jed Lewis

Title

Vice President - Secretary

Phone

(402) 652-3217

Specialties & licenses 4

Addresses

Other names 1

• Medicine Man Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NE2 enrollments

Enrollment records 2

Tax ID family

Medicine Man Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Spamm LLC

  dba Medicine Man Pharmacy

  • Long Term Care Pharmacy
  • Schuyler, NE
  • NPI 1235005380
  NPD tax ID

Locations

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

{
    "created_epoch": "1549584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1508321027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 437",
            "city": "NORTH BEND",
            "state": "NE",
            "postal_code": "686490437",
            "telephone_number": "402-652-3217",
            "fax_number": "402-652-8219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 W 16TH ST",
            "city": "SCHUYLER",
            "state": "NE",
            "postal_code": "686611668",
            "telephone_number": "402-352-3020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "544 Seward St",
            "address_purpose": "LOCATION",
            "city": "Seward",
            "state": "NE",
            "postal_code": "684342008",
            "country_code": "US",
            "telephone_number": "402-643-3332",
            "fax_number": "402-643-3807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPAMM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JED",
        "authorized_official_title_or_position": "VICE PRESIDENT - SECRETARY",
        "authorized_official_telephone_number": "402-652-3217"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicine Man Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medicine Man Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stacy Ann Seda, PTA
• Geralyn Denise Shannon
• Dina Silverio
• Lori Simanek, CCC-SLP
• Spamm LLC (Medicine Man Pharmacy)
• Shelley Tamasi
• Kristy Lynn Theilen, BA
• Elvin A Torres
• Rosalba Valerio
• Cori Kay Vavricek, RN

• Community/Retail Pharmacy in Schuyler, NE
• Providers in Schuyler, NE by specialty
• Community/Retail Pharmacy in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.