Active NPI
Red Cross Pharmacy, Inc.
- Community/Retail Pharmacy
- Marshall, MO
National Provider Identifier
1740368604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 000132
- Legal business name
- RED CROSS PHARMACY, INC.
- Practice address
- 161 S Benton Ave
Marshall, MO 65340-1836 - Phone
- (660) 886-5533
- Fax
- (660) 886-2121
- NPI assigned
- Nov 1, 2006
- 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. Scott Brenden Hartwig
- Title
- Co-President/Ceo (Owner)
- Phone
- (660) 886-5535
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 000132 | MO | |
| Community/Retail Pharmacy | 3336C0003X | 000132 | MO | Primary |
Addresses
Primary practice location
161 S Benton Ave
Marshall, MO 65340-1836
Mailing address
PO Box 917
Marshall, MO 65340-0917
Phone (660) 886-5533
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 600305205 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040929000382 | MO | Part B Supplier - Mass Immunization (Roster Biller Only) | 2466421102 |
20 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Excelsior Springs, MO; Marshall, MO |
Other NPIs on the same Medicare enrollment 19
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Oxygen Equipment & Supplies (DME)
- Marshall, MO
- NPI 1467525493
Member Of
Locations
161 S Benton Ave
Marshall, MO 65340
Phone (660) 886-5533
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1304985600000",
"number": "1740368604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 917",
"city": "MARSHALL",
"state": "MO",
"postal_code": "653400917",
"telephone_number": "660-886-5533",
"fax_number": "660-886-6320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 S BENTON AVE",
"city": "MARSHALL",
"state": "MO",
"postal_code": "653401836",
"telephone_number": "660-886-5533",
"fax_number": "660-886-2121"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RED CROSS PHARMACY, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-01",
"last_updated": "2011-05-10",
"status": "A",
"authorized_official_last_name": "HARTWIG",
"authorized_official_first_name": "SCOTT",
"authorized_official_middle_name": "BRENDEN",
"authorized_official_title_or_position": "CO-PRESIDENT/CEO (OWNER)",
"authorized_official_telephone_number": "660-886-5535",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "MO",
"license": "000132",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MO",
"license": "000132",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "600305205",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marshall, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.