Skagway Disc Dept. Stores, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2113 Issued in NE

Legal business name

SKAGWAY DISC DEPT. STORES, INC.

Doing business as

Skagway Pharmacy # 2

Practice address

1607 S Locust St
Grand Island, NE 68801-8246

Phone

(308) 384-9120

Fax

(308) 398-9021

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Tim W Bolton

Title

Secretary

Phone

(308) 384-8222

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Skagway Pharmacy # 2 Doing business as

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679615819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1647",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688021647",
            "telephone_number": "308-384-9120",
            "fax_number": "308-398-9021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 S LOCUST ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688018246",
            "telephone_number": "308-384-9120",
            "fax_number": "308-398-9021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKAGWAY DISC DEPT. STORES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOLTON",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "308-384-8222",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NE",
            "license": "2113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP OR NABP NO.",
            "identifier": "2813942",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skagway Pharmacy # 2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanya Simonson
• Bradley Gene Singer, M.D.
• Shelby Rae Singer
• Shailendra Singhal, DMD
• Amy J Sjoholm, LMHP
• Skagway Disc Dept. Stores, Inc.
• Shalie Lynn Sklenar
• Lucas Gilbert Skrdlant
• Bonnie Lou Slaymaker
• Mary Slevin, SLP

• Community/Retail Pharmacy in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Community/Retail Pharmacy in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.