NPIMap

Organization Active NPI

Red Cross Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Kearney, MO
National Provider Identifier
1669550547
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
006330 Issued in MO
Legal business name
RED CROSS PHARMACY, INC.
Practice address
101 W State Route 92
Suite a
Kearney, MO 64060-7590
Phone
(816) 635-4485
Fax
(816) 628-4649
NPI assigned
Nov 1, 2006
Last updated
Apr 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Authorized official

Name
Mr. Scott Brenden Hartwig
Title
Co-President/Ceo (Owner)
Phone
(660) 886-5535

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 006930 MO
Community/Retail Pharmacy 3336C0003X 006330 MO Primary

Addresses

Primary practice location

101 W State Route 92
Suite a
Kearney, MO 64060-7590

Mailing address

52 E Arrow St
Marshall, MO 65340-2101
Phone (660) 886-5535

Other identifiers 1

IdentifierTypeStateIssuer
600059208MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040929000382 MO Part B Supplier - Mass Immunization (Roster Biller Only) 2466421102 20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Excelsior Springs, MO; Marshall, MO

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209513600000",
    "number": "1669550547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 E ARROW ST",
            "city": "MARSHALL",
            "state": "MO",
            "postal_code": "653402101",
            "telephone_number": "660-886-5535",
            "fax_number": "660-886-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W STATE ROUTE 92",
            "address_2": "SUITE A",
            "city": "KEARNEY",
            "state": "MO",
            "postal_code": "640607590",
            "telephone_number": "816-635-4485",
            "fax_number": "816-628-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED CROSS PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "HARTWIG",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "BRENDEN",
        "authorized_official_title_or_position": "CO-PRESIDENT/CEO (OWNER)",
        "authorized_official_telephone_number": "660-886-5535",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": "006930",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "006330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600059208",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.