NPIMap

Organization Active NPI

Dekalb Memorial Pharmacare LLC

Doing business as DeKalb Health PharmaCare Garrett

  • Community/Retail Pharmacy
  • Garrett, IN
National Provider Identifier
1639620669
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
60006582A Issued in IN
Legal business name
DEKALB MEMORIAL PHARMACARE LLC
Doing business as
DeKalb Health PharmaCare Garrett
Practice address
1350 S Randolph St
Garrett, IN 46738-1971
Phone
(260) 553-9200
Fax
(260) 553-9201
NPI assigned
Oct 14, 2016
Last updated
Oct 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

Name
Stanton Risser
Title
Acfo
Phone
(260) 266-9380

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 60006582A IN Primary

Addresses

Primary practice location

1350 S Randolph St
Garrett, IN 46738-1971

Mailing address

1350 S Randolph St
Garrett, IN 46738-1971
Phone (260) 553-9200

Other identifiers 1

IdentifierTypeStateIssuer
2164066OtherPK

Other names 1

  • DeKalb Health PharmaCare Garrett Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dekalb Health Pharmacare2 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.

Locations

1350 S Randolph St
Garrett, IN 46738
Phone (260) 553-9200

Practitioners & affiliated clinicians

Practitioners 4

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": "1476403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1639620669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 S RANDOLPH ST",
            "city": "GARRETT",
            "state": "IN",
            "postal_code": "467381971",
            "telephone_number": "260-553-9200",
            "fax_number": "260-553-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S RANDOLPH ST",
            "city": "GARRETT",
            "state": "IN",
            "postal_code": "467381971",
            "telephone_number": "260-553-9200",
            "fax_number": "260-553-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB MEMORIAL PHARMACARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-14",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "RISSER",
        "authorized_official_first_name": "STANTON",
        "authorized_official_title_or_position": "ACFO",
        "authorized_official_telephone_number": "260-266-9380"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "60006582A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2164066",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeKalb Health PharmaCare Garrett",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Garrett, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.