Organization Active NPI

Smithburg Retail Enterprise, Inc.

Doing business as Hoffman Drug

  • Community/Retail Pharmacy
  • Limon, CO
National Provider Identifier
1548365992
Registry record updated Aug 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SMITHBURG RETAIL ENTERPRISE, INC.
Doing business as
Hoffman Drug
Practice address
900 Main St.
Limon, CO 80828
Phone
(719) 775-2371
NPI assigned
Sep 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2017

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

Authorized official

Name
Ryan SmithburgNPI 1285766170
Title
Owner
Phone
(719) 775-2371

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary
Long Term Care Pharmacy 3336L0003X 780000001 CO

Addresses

Primary practice location

900 Main St.
Limon, CO 80828

Mailing address

PO Box 609
Limon, CO 80828-0609

Other identifiers 1

IdentifierTypeStateIssuer
60328819MedicaidCO

Other names 1

  • Hoffman Drug Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20091023000278 CO Part B Supplier - Mass Immunization (Roster Biller Only) 3375680366 Practice locations: Limon, CO
O20100930093848 CO DME Supplier - PharmacyDME Supplier - Orthotic Personnel 3375680366 Practice locations: Limon, CO

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D0945597Hoffman Drug900 Main St, Limon, CO 80828Certificate of waiverMar 11, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Smithburg Retail900 Main Street, Limon, CO 80828(719) 775-2371 Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Wheelchairs (Standard Manual)|Orthoses: Off-The-Shelf|Urological Supplies|Nebulizer Equipment and/or Supplies|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Accepts assignmentParticipating since Aug 23, 2009

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503360000000",
    "number": "1548365992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 609",
            "city": "LIMON",
            "state": "CO",
            "postal_code": "808280609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN ST.",
            "city": "LIMON",
            "state": "CO",
            "postal_code": "80828",
            "telephone_number": "719-775-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITHBURG RETAIL ENTERPRISE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2017-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITHBURG",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-775-2371"
    },
    "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": "CO",
            "license": "780000001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60328819",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hoffman Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Limon, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.