NPIMap

Organization Active NPI

Glenwood Resource Center

  • Institutional Pharmacy
  • Glenwood, IA
National Provider Identifier
1669414447
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
Legal business name
GLENWOOD RESOURCE CENTER
Practice address
711 S Vine St
Attn: Pharmacy
Glenwood, IA 51534-1927
Phone
(712) 525-1316
Fax
(712) 525-1262
NPI assigned
Jun 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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

Authorized official

Name
Gary Anders
Title
Superintendent of Facility
Phone
(712) 525-1251

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X Primary
Long Term Care Pharmacy 3336L0003X 559 IA

Addresses

Primary practice location

711 S Vine St
Attn: Pharmacy
Glenwood, IA 51534-1927

Mailing address

711 S Vine St
Attn: Pharmacy
Glenwood, IA 51534-1927
Phone (712) 525-1316

Other identifiers 2

IdentifierTypeStateIssuer
0140103MedicaidIA
2029593OtherPK

Other names 1

  • Glenwood Resource Center Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Department of Human Services Glenwood Resource Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409788800000",
    "number": "1669414447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 S VINE ST",
            "address_2": "ATTN: PHARMACY",
            "city": "GLENWOOD",
            "state": "IA",
            "postal_code": "515341927",
            "telephone_number": "712-525-1316",
            "fax_number": "712-525-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 S VINE ST",
            "address_2": "ATTN: PHARMACY",
            "city": "GLENWOOD",
            "state": "IA",
            "postal_code": "515341927",
            "telephone_number": "712-525-1316",
            "fax_number": "712-525-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENWOOD RESOURCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2014-09-04",
        "status": "A",
        "authorized_official_last_name": "ANDERS",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "SUPERINTENDENT OF FACILITY",
        "authorized_official_telephone_number": "712-525-1251"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IA",
            "license": "559",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0140103",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2029593",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glenwood Resource Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glenwood, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; 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.