West Old Corner Drug, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

WEST OLD CORNER DRUG, INC

Doing business as

Old Corner Drug

Practice address

200 N Main St
West, TX 76691-1207

Phone

(254) 826-5122

Fax

(254) 826-3768

NPI assigned

Oct 26, 2006

Last updated

Mar 6, 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

Dr. Randy James Niemeyer, PHARMDNPI 1417274705

Title

Pharmacist/President

Phone

(254) 826-5122

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• OLD CORNER DRUG Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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.

• Randy James Niemeyer, PHARMD

  • Pharmacist
  • West, TX
  • NPI 1417274705
  NPD Authorized official

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614988800000",
    "number": "1518042803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N MAIN ST",
            "city": "WEST",
            "state": "TX",
            "postal_code": "766911207",
            "telephone_number": "254-826-5122",
            "fax_number": "254-826-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N MAIN ST",
            "city": "WEST",
            "state": "TX",
            "postal_code": "766911207",
            "telephone_number": "254-826-5122",
            "fax_number": "254-826-3768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST OLD CORNER DRUG, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2021-03-06",
        "certification_date": "2021-03-06",
        "status": "A",
        "authorized_official_last_name": "NIEMEYER",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PHARMACIST/PRESIDENT",
        "authorized_official_telephone_number": "254-826-5122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16437801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142315",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OLD CORNER DRUG",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OLD CORNER DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lauren Nicole Wernet
• West Hospital Authority (West Assisted Living)
• West Isd
• West Medical and Surgical Clinic Association
• West Oak Medical Clinic PA
• West Old Corner Drug, Inc (Old Corner Drug)
• West Station Enterprise Inc
• West Voluntary Ambulance Association (West Volunteer Emergency Medical Service)
• Jessica Leigh Wilkinson, PTA
• Jennifer Michele Wilson, LVN

• Community/Retail Pharmacy in West, TX
• Providers in West, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.