Active NPI
Skagway Disc Dept. Stores, Inc.
- Community/Retail Pharmacy
- Grand Island, NE
National Provider Identifier
1720120025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 931
- Legal business name
- SKAGWAY DISC DEPT. STORES, INC.
- Doing business as
- Skagway Pharmacy # 1
- Practice address
- 620 State St
Grand Island, NE 68801-3552 - Phone
- (308) 384-8228
- Fax
- (308) 384-6835
- NPI assigned
- Feb 13, 2007
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 931 | NE | Primary |
Addresses
Primary practice location
620 State St
Grand Island, NE 68801-3552
Mailing address
PO Box 1647
Grand Island, NE 68802-1647
Phone (308) 384-8228
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2800779 | Other | NE | NCPDP OR NABP NO. |
Other names 1
- Skagway Pharmacy # 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Grand Island, NE
- NPI 1043501497
NPI Registry JSON
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": "1720120025",
"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": "308-384-8228",
"fax_number": "308-384-6835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 STATE ST",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "688013552",
"telephone_number": "308-384-8228",
"fax_number": "308-384-6835"
}
],
"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": "931",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP OR NABP NO.",
"identifier": "2800779",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Skagway Pharmacy # 1",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Grand Island, NE
Sources for this page
- 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.