NPIMap

Organization Active NPI

West Holt Memorial Hospital

Doing business as West Holt Pharmacy

  • Community/Retail Pharmacy
  • Atkinson, NE
National Provider Identifier
1811913767
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
687 Issued in NE
Legal business name
WEST HOLT MEMORIAL HOSPITAL
Doing business as
West Holt Pharmacy
Practice address
313 W Pearl St
Atkinson, NE 68713-4958
Phone
(402) 925-2651
Fax
(402) 925-2652
NPI assigned
Jul 14, 2006
Last updated
Dec 17, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
WEST HOLT MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Authorized official

Name
Jeremy Bauer
Title
Cfo
Phone
(402) 925-1947

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 687 NE Primary

Addresses

Primary practice location

313 W Pearl St
Atkinson, NE 68713-4958

Mailing address

PO Box 277
Atkinson, NE 68713-0277
Phone (402) 925-2651

Other identifiers 2

IdentifierTypeStateIssuer
10025343800MedicaidNE
2053169OtherPK

Other names 1

  • WEST HOLT PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170504002486 NE DME Supplier - Pharmacy 2264419878 Practice locations: Atkinson, NE

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
West Holt Medical Clini4 organizations share this tax ID, including this one
Part of
West Holt Medical Clini

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1811913767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277",
            "city": "ATKINSON",
            "state": "NE",
            "postal_code": "687130277",
            "telephone_number": "402-925-2651",
            "fax_number": "402-925-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 W PEARL ST",
            "city": "ATKINSON",
            "state": "NE",
            "postal_code": "687134958",
            "telephone_number": "402-925-2651",
            "fax_number": "402-925-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST HOLT MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST HOLT MEMORIAL HOSPITAL",
        "enumeration_date": "2006-07-14",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "BAUER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "402-925-1947"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NE",
            "license": "687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025343800",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2053169",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WEST HOLT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WEST HOLT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atkinson, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.