NPIMap

Organization Active NPI

Peoples Community Health Clinic, Inc.

  • Pharmacy
  • Waterloo, IA
National Provider Identifier
1720108541
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
406 Issued in IA
Legal business name
PEOPLES COMMUNITY HEALTH CLINIC, INC.
Practice address
905 Franklin St
Waterloo, IA 50703-4407
Phone
(319) 272-4300
Fax
(319) 272-4489
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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

Authorized official

Name
Chris Kemp
Title
Coo
Phone
(319) 874-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 406 IA Primary

Addresses

Primary practice location

905 Franklin St
Waterloo, IA 50703-4407

Mailing address

905 Franklin St
Waterloo, IA 50703-4407
Phone (319) 874-3000

Other identifiers 1

IdentifierTypeStateIssuer
0076372MedicaidIA

Other names 1

  • Peoples Clinic Pharmacy Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL Barracuda
Other URL Barracuda

National Provider Directory

National Provider Directory
Tax ID family
Peoples Clinic Pharmacy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572393600000",
    "number": "1720108541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 FRANKLIN ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507034407",
            "telephone_number": "319-874-3000",
            "fax_number": "319-874-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 FRANKLIN ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507034407",
            "telephone_number": "319-272-4300",
            "fax_number": "319-272-4489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEOPLES COMMUNITY HEALTH CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2019-10-30",
        "status": "A",
        "authorized_official_last_name": "KEMP",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "319-874-3000"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IA",
            "license": "406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076372",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Barracuda",
            "affiliation": "N",
            "address_1": "905 Franklin St",
            "city": "Waterloo",
            "state": "IA",
            "country_code": "US",
            "postal_code": "507034407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Barracuda",
            "affiliation": "N",
            "address_1": "905 Franklin St",
            "city": "Waterloo",
            "state": "IA",
            "country_code": "US",
            "postal_code": "507034407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Peoples Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Peoples Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; 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.