Taylor Pharmacy Revoc Trust

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

145 Issued in IA

Legal business name

TAYLOR PHARMACY REVOC TRUST

Doing business as

Taylor Pharmacy

Practice address

122 124 North 16TH St
Clarinda, IA 51632-1601

Phone

(712) 542-3522

Fax

(712) 542-2329

NPI assigned

Feb 15, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gordon C Reed, RPH

Title

Owner Pharmacist

Phone

(712) 542-3522

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• TAYLOR PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689717647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122-124 NORTH 16TH ST",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516321601",
            "telephone_number": "712-542-3522",
            "fax_number": "712-542-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 124 NORTH 16TH ST",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516321601",
            "telephone_number": "712-542-3522",
            "fax_number": "712-542-2329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAYLOR PHARMACY REVOC TRUST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "712-542-3522",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019758000001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1604277",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1604277",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1604277",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8530830",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0036194",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TAYLOR PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brandy Sue Stephens, L.M.S.W.
• Valeria V. Stickler, VSTCLP
• Kenda Leigh Stogdill, PT, DPT
• James R Stone, MD
• Kylie Tate
• Marcy Barbara Taylor, LMSW
• Marcy Lynn Thummel-Howard, TLMHC
• Urology Center, PC
• Brittany Morgan Van Fosson, LMSW
• Courtney Jalene Vestal, LMSW

• Community/Retail Pharmacy in Clarinda, IA
• Providers in Clarinda, IA by specialty
• Community/Retail Pharmacy in Iowa

• 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.