NPIMap

Organization Active NPI

Red Cross Pharmacy, Inc

Doing business as Red Cross Pharmacy

  • Community/Retail Pharmacy
  • Marshall, MO
National Provider Identifier
1760717268
Registry record updated Sep 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2014031329 Issued in MO
Legal business name
RED CROSS PHARMACY, INC
Doing business as
Red Cross Pharmacy
Practice address
2303 S. Highway 65
Suite B
Marshall, MO 65340-3735
Phone
(660) 831-1687
Fax
(660) 831-1688
NPI assigned
Oct 16, 2009
Last updated
Sep 19, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2014

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

Authorized official

Name
Scott Hartwig
Title
President/Ceo
Phone
(660) 886-5535

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2009032034 MO
Community/Retail Pharmacy 3336C0003X 2014031329 MO Primary

Addresses

Primary practice location

2303 S. Highway 65
Suite B
Marshall, MO 65340-3735

Mailing address

PO Box 917
Marshall, MO 65340-0917
Phone (660) 886-5535

Other identifiers 1

IdentifierTypeStateIssuer
606154102MedicaidMO

Other names 1

  • Red Cross Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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.

View all 19

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411084800000",
    "number": "1760717268",
    "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": "660-886-5535",
            "fax_number": "660-886-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2303 S. HIGHWAY 65",
            "address_2": "SUITE B",
            "city": "MARSHALL",
            "state": "MO",
            "postal_code": "653403735",
            "telephone_number": "660-831-1687",
            "fax_number": "660-831-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED CROSS PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-16",
        "last_updated": "2014-09-19",
        "status": "A",
        "authorized_official_last_name": "HARTWIG",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "660-886-5535"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2009032034",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2014031329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606154102",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Cross Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 19, 2014; 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.

Verify at the official NPI Registry.