Abc Medcare. LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

52-02902 Issued in WY

Legal business name

ABC MEDCARE. LLC

Practice address

120 North 7TH Street
Worland, WY 82401

Phone

(307) 278-2070

Fax

(307) 347-3085

NPI assigned

Feb 20, 2007

Last updated

Nov 17, 2023By 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

Robert Edward Callan

Title

Vice President General Counsel & SE

Phone

(307) 278-2769

Specialties & licenses 1

Addresses

Other names 2

• Admiral Beverage Corporation Other name
• Admiral Beverage Corporation d/b/a ABC Medcare Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1538204375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 NORTH 7TH STREET",
            "city": "WORLAND",
            "state": "WY",
            "postal_code": "82401",
            "telephone_number": "307-278-2070",
            "fax_number": "307-347-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 NORTH 7TH STREET",
            "city": "WORLAND",
            "state": "WY",
            "postal_code": "82401",
            "telephone_number": "307-278-2070",
            "fax_number": "307-347-3085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC MEDCARE. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "CALLAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "VICE PRESIDENT GENERAL COUNSEL & SE",
        "authorized_official_telephone_number": "307-278-2769"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WY",
            "license": "52-02902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Admiral Beverage Corporation",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Admiral Beverage Corporation",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Admiral Beverage Corporation d/b/a ABC Medcare",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sameh G Abuerreish, MD
• Kimberly R Accurso, LPC
• Advanced Practice, LLC
• David Manasseh Ahlstrom, PHARM.D.
• Alpha Medical Inc

• Community/Retail Pharmacy in Worland, WY
• Providers in Worland, WY by specialty
• Community/Retail Pharmacy in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.