Greenhaw Pharmacy, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

210227 Issued in KS

Legal business name

GREENHAW PHARMACY, INC

Doing business as

Hillsboro Hometown Pharmacy

Practice address

507 N Ash St
Hillsboro, KS 67063

Phone

(620) 947-3784

Fax

(620) 947-2801

NPI assigned

Oct 20, 2006

Last updated

Oct 16, 2020By 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

Eric Driggers, PHARMDNPI 1124436050

Title

President, Owner

Phone

(620) 947-3784

Specialties & licenses 5

Addresses

Other identifiers 3

Other names 1

• Hillsboro Hometown Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in KS2 enrollments

Enrollment records 2

Tax ID family

Greenhaw Pharmacy Inc2 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.

• Greenhaw Pharmacy, Inc

  dba Hillsboro Hometown Pharmacy - LTC

  • Long Term Care Pharmacy
  • Hillsboro, KS
  • NPI 1184222622
  NPD tax ID

Locations

Practitioners 2

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.

• Eric Driggers, PHARMD

  • Pharmacist
  • Hillsboro, KS
  • NPI 1124436050
  NPD Authorized official
• Gina Georgette Edwards, PHARM.D.

  • Pharmacist
  • Hillsboro, KS
  • NPI 1891830915
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602806400000",
    "number": "1578645362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "HILLSBORO",
            "state": "KS",
            "postal_code": "670630188",
            "telephone_number": "620-947-3784",
            "fax_number": "620-947-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 N ASH ST",
            "city": "HILLSBORO",
            "state": "KS",
            "postal_code": "67063",
            "telephone_number": "620-947-3784",
            "fax_number": "620-947-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENHAW PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A",
        "authorized_official_last_name": "DRIGGERS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT, OWNER",
        "authorized_official_telephone_number": "620-947-3784",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KS",
            "license": "210227",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200406440A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200406440B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2031032",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hillsboro Hometown Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Benjamin P Fritsch, PTA
• Donna Jane Glover, LPC-T
• Nancy Graber, RN
• Greenhaw Pharmacy
• Greenhaw Pharmacy, Inc (Hillsboro Hometown Pharmacy - LTC)
• Grene Vision Group LLC
• Tristin Danielle Headley
• Herington Hospital Inc
• Herington Hospital Inc (Hillsboro Healthcare Clinic)
• Herington Municipal Hospital (Hillsboro HealthCare Clinic)

• Community/Retail Pharmacy in Hillsboro, KS
• Providers in Hillsboro, KS by specialty
• Community/Retail Pharmacy in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; 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.