Greenwood Drug Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

334 Issued in IA

Legal business name

GREENWOOD DRUG INC

Practice address

2104 Kimball Ave
Waterloo, IA 50702-5037

Phone

(319) 234-6673

Fax

(319) 226-5898

NPI assigned

Oct 9, 2006

Organization subpart

No

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

Authorized official

Name

Joseph Patrick Greenwood, PHARM.D

Title

President/Pic

Phone

(319) 236-8067

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• GREENWOOD DRUG, INC. Former legal business name

Medicare fee-for-service enrollment

Enrolled in IA2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Greenwood Drug, Inc.

  • Community/Retail Pharmacy
  • Waterloo, IA
  • NPI 1871542977

  9931207677

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

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

• Greenwood Drug, Inc.

  • Community/Retail Pharmacy
  • Waterloo, IA
  • NPI 1871542977

  O20071106000785

  Same enrollment

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Holly Bradley, PHARM D

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Waterloo, IA
  • NPI 1508015280
  NPD (past)
• Jennifer Leigh Clayton, PHARMD

  • Pharmacist
  • Waterloo, IA
  • NPI 1578513891
  NPD (past)
• Julianna Marie Kula, PHARM D

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Waterloo, IA
  • NPI 1942451927
  NPD (past)

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1811084056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 KIMBALL AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025037",
            "telephone_number": "319-234-6673",
            "fax_number": "319-226-5898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 KIMBALL AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025037",
            "telephone_number": "319-234-6673",
            "fax_number": "319-226-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENWOOD DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "GREENWOOD",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT/PIC",
        "authorized_official_telephone_number": "319-236-8067",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811084056",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0208965",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2134076",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREENWOOD DRUG, INC.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Matthew J Grady, M.D.
• Cyd Q. Grafft, ARNP
• Michelle L Graham, M.D.
• Sommer J Grant, ARNP
• Emily Ann Grarup, ARNP
• Greenwood Drug, Inc.
• Greenwood Drug, Inc.
• Joseph Greenwood, PHARM D
• Robert John Greenwood, RPH
• Dillon Greer, HIS

• Community/Retail Pharmacy in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Community/Retail Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.