NPIMap

Organization Active NPI

Emissary Professional Group

  • Mail Order Pharmacy
  • Casper, WY
National Provider Identifier
1568640928
Registry record updated Oct 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mail Order PharmacyTaxonomy code 3336M0002X
License
52-03586 Issued in WY
Legal business name
EMISSARY PROFESSIONAL GROUP
Practice address
2546 E 2ND St
BLDG 100
Casper, WY 82609-2062
Phone
(307) 237-7751
Fax
(307) 237-7448
NPI assigned
Feb 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2010

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

Authorized official

Name
Timothy Renz, RPH
Title
Owner
Phone
(307) 472-0597

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Mail Order Pharmacy 3336M0002X 52-03586 WY Primary

Addresses

Primary practice location

2546 E 2ND St
BLDG 100
Casper, WY 82609-2062

Mailing address

2546 E 2ND St
BLDG 100
Casper, WY 82609-2062
Phone (307) 237-7751

Other identifiers 1

IdentifierTypeStateIssuer
5203586OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • EMISSARY HMO PHARMACY Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286323200000",
    "number": "1568640928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2546 E 2ND ST",
            "address_2": "BLDG 100",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826092062",
            "telephone_number": "307-237-7751",
            "fax_number": "307-237-7448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2546 E 2ND ST",
            "address_2": "BLDG 100",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826092062",
            "telephone_number": "307-237-7751",
            "fax_number": "307-237-7448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMISSARY PROFESSIONAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-07",
        "last_updated": "2010-10-06",
        "status": "A",
        "authorized_official_last_name": "RENZ",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-472-0597",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "WY",
            "license": "52-03586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5203586",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EMISSARY HMO PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Casper, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.