NPIMap

Organization Active NPI

Floyd Valley Healthcare

Doing business as Floyd Valley Pharmacy

  • Community/Retail Pharmacy
  • Le Mars, IA
National Provider Identifier
1710765433
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
FLOYD VALLEY HEALTHCARE
Doing business as
Floyd Valley Pharmacy
Practice address
714 Lincoln St NE Ste 100
Le Mars, IA 51031-3314
Phone
(712) 546-3738
Fax
(712) 546-3747
NPI assigned
Sep 15, 2023
Last updated
Aug 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Authorized official

Name
Daryl J Friedenbach
Title
Cfo
Phone
(712) 546-3338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

714 Lincoln St NE Ste 100
Le Mars, IA 51031-3314

Mailing address

714 Lincoln St NE Ste 100
Le Mars, IA 51031-3314
Phone (712) 546-3738

Other names 1

  • Floyd Valley Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240801003577 IA Part B Supplier - Pharmacy 2769385475 Practice locations: Le Mars, IA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Floyd Valley Healthcare8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

714 Lincoln St NE
Ste 100
Le Mars, IA 51031
Phone (712) 546-3338

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Floyd Valley HealthcareLe Mars, IA, CCN 161368 Hospital Operational/Managerial Control Nov 7, 2007
Floyd Valley HealthcareLe Mars, IA, CCN 16Z368 Hospital Operational/Managerial Control (100%) Dec 1, 1966
Floyd Valley Hospital Community Health ServiceLe Mars, IA, CCN 167105 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2025
Dec 10, 2009

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1710765433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 LINCOLN ST NE STE 100",
            "city": "LE MARS",
            "state": "IA",
            "postal_code": "510313314",
            "telephone_number": "712-546-3738",
            "fax_number": "712-546-3747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 LINCOLN ST NE STE 100",
            "city": "LE MARS",
            "state": "IA",
            "postal_code": "510313314",
            "telephone_number": "712-546-3738",
            "fax_number": "712-546-3747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLOYD VALLEY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-15",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "FRIEDENBACH",
        "authorized_official_first_name": "DARYL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "712-546-3338"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Floyd Valley Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Le Mars, IA

Sources for this page

Verify at the official NPI Registry.