Organization Active NPI

Kwasniewski Enterprises Inc

Doing business as Cornwell Drug

  • Community/Retail Pharmacy
  • Webster, SD
National Provider Identifier
1659361640
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1001821 Issued in SD
Legal business name
KWASNIEWSKI ENTERPRISES INC
Doing business as
Cornwell Drug
Practice address
701 Main St
Webster, SD 57274-1305
Phone
(605) 345-3351
Fax
(605) 345-3201
NPI assigned
Oct 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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

Authorized official

Name
Robert KwasniewskiNPI 1245348788
Title
President
Phone
(605) 345-3351

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 1001821 SD Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

701 Main St
Webster, SD 57274-1305

Mailing address

PO Box 490
Webster, SD 57274-0490
Phone (605) 345-3351

Other identifiers 2

IdentifierTypeStateIssuer
8500742MedicaidSD
2093886OtherPK

Other names 1

  • CORNWELL DRUG Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20100930054109 SD DME Supplier - Pharmacy 5991817504 Practice locations: Webster, SD
O20181024001057 SD Part B Supplier - Mass Immunization (Roster Biller Only) 5991817504 Practice locations: Webster, SD
O20220728002799 SD Part B Supplier - Independent Clinical Laboratory 5991817504 Practice locations: Webster, SD

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
43D2214636Cornwell Drug701 Main St, Webster, SD 57274Certificate of waiverFeb 23, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Cornwell Drug701 Main St, Webster, SD 57274-1305(605) 345-3351 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Insulin Infusion Pumps and/or Supplies|Canes and/or Crutches|Walkers|Wheelchairs (Standard Manual)|Wheelchairs (Standard Manual Related Accessories)|Orthoses: Off-The-Shelf|Ostomy Supplies|Urological Supplies|Enteral Nutrie… Does not accept assignmentParticipating since Jun 30, 2001

National Provider Directory

National Provider Directory

Locations

701 Main St
Webster, SD 57274
Phone (605) 345-3351

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": "1129852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543881600000",
    "number": "1659361640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "WEBSTER",
            "state": "SD",
            "postal_code": "572740490",
            "telephone_number": "605-345-3351",
            "fax_number": "605-345-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MAIN ST",
            "city": "WEBSTER",
            "state": "SD",
            "postal_code": "572741305",
            "telephone_number": "605-345-3351",
            "fax_number": "605-345-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KWASNIEWSKI ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-21",
        "last_updated": "2018-12-04",
        "status": "A",
        "authorized_official_last_name": "KWASNIEWSKI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "605-345-3351"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SD",
            "license": "1001821",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8500742",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2093886",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORNWELL DRUG",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CORNWELL DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Webster, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; 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.