NPIMap

Organization Active NPI

Neighborhood LTC Pharmacy Inc.

Doing business as Neighborhood LTC Pharmacy

  • Long Term Care Pharmacy
  • Urbandale, IA
National Provider Identifier
1619668258
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
NEIGHBORHOOD LTC PHARMACY INC.
Doing business as
Neighborhood LTC Pharmacy
Practice address
10711 Justin Dr
Urbandale, IA 50322-3720
Phone
(515) 989-8301
Fax
(515) 989-8302
NPI assigned
May 16, 2023
Last updated
Sep 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Authorized official

Name
Marissa McMahon, PHARMDNPI 1871035964
Title
Coo
Phone
(402) 488-1184

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

10711 Justin Dr
Urbandale, IA 50322-3720

Mailing address

1265 S Cotner Blvd Ste 30
Lincoln, NE 68510-4924
Phone (402) 488-1184

Other names 1

  • NEIGHBORHOOD LTC PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20231128003419 IA DME Supplier - Pharmacy 8628290673 Practice locations: Urbandale, IA
O20240816003850 IA Part B Supplier - Pharmacy 8628290673 Practice locations: Urbandale, IA

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Neighborhood LTC Pharmacy10711 Justin Dr, Urbandale, IA 50322-3720(515) 989-8301 Nebulizer Drugs Accepts assignmentParticipating since Dec 21, 2020

National Provider Directory

National Provider Directory
Tax ID family
Neighborhood LTC Pharmacy10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the 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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1619668258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 S COTNER BLVD STE 30",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104924",
            "telephone_number": "402-488-1184",
            "fax_number": "402-488-1187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10711 JUSTIN DR",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503223720",
            "telephone_number": "515-989-8301",
            "fax_number": "515-989-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIGHBORHOOD LTC PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-16",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "MCMAHON",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "402-488-1184",
        "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": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEIGHBORHOOD LTC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NEIGHBORHOOD LTC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Urbandale, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.