NPIMap

Organization Active NPI

Pharma340 LLC

Doing business as Community Pharmacy of Gowrie

  • Community/Retail Pharmacy
  • Gowrie, IA
National Provider Identifier
1780143016
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PHARMA340 LLC
Doing business as
Community Pharmacy of Gowrie
Practice address
1800 Main St
Gowrie, IA 50543-7438
Phone
(515) 352-3876
NPI assigned
Mar 16, 2019
Last updated
Dec 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Authorized official

Name
Steven Donnelly
Title
Vice President
Phone
(210) 441-2036

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

1800 Main St
Gowrie, IA 50543-7438

Mailing address

1321 W Main St
Lake City, IA 51449-1585
Phone (712) 830-5443

Other names 1

  • Community Pharmacy of Gowrie Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190829002201 IA Part B Supplier - Mass Immunization (Roster Biller Only) 2567799505 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rockwell City, IA; Sac City, IA; Lake View, IA; Lake City, IA; Dunlap, IA; Gowrie, IA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Pharma340 LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1552694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734393600000",
    "number": "1780143016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 W MAIN ST",
            "city": "LAKE CITY",
            "state": "IA",
            "postal_code": "514491585",
            "telephone_number": "712-830-5443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MAIN ST",
            "city": "GOWRIE",
            "state": "IA",
            "postal_code": "505437438",
            "telephone_number": "515-352-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMA340 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-16",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A",
        "authorized_official_last_name": "DONNELLY",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "210-441-2036"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Pharmacy of Gowrie",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Pharmacy of Gowrie",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gowrie, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.