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Weimer Drug Co., Inc.

Organization Active NPI Durable Medical Equipment & Medical Supplies · Clay Center, KS

NPI 1821119306 · NPPES record last updated Oct 8, 2020

Key facts

NPI
1821119306
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
License
207255 (KS)
Legal business name
WEIMER DRUG CO., INC.
Practice address
422 Lincoln Ave
Clay Center, KS 67432-2908
Phone
(785) 632-3115
Fax
(785) 632-3777
NPI assigned
Apr 3, 2007
Organization subpart
No

Authorized official

Name
Lindy Clark
Title
DME Billing Administrator
Phone
(785) 632-3115

Other NPIs with the same Medicare PAC ID 2

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

Corporate family (same tax ID) 6

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KS

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930088551 KS DME Supplier - Pharmacy
DME Supplier - Medical Supply Company With Orthotic Personnel
DME Supplier - Medical Supply Company With Registered Pharmacist
DME Supplier - Oxygen & Equipment		 4688712714 Practice locations: Clay Center, KS

National Provider Directory

Tax ID family
Weimer Drug Co Inc (7 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 207255 KS Yes
Oxygen Equipment & Supplies (DME) 332BX2000X 207255 KS
Prosthetic/Orthotic Supplier 335E00000X 2-07255 KS

Addresses

Primary practice location

422 Lincoln Ave
Clay Center, KS 67432-2908

Mailing address

422 Lincoln Ave
Clay Center, KS 67432-2908
Phone (785) 632-3115

Other identifiers

IdentifierTypeStateIssuer
1821119306OtherKSDME NPI
100435190BMedicaidKS
1306840855OtherKSPHARMACY NPI

Other names

  • PATTERSON HEALTH MART PHARMACY Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 8, 2020.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1821119306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 LINCOLN AVE",
            "city": "CLAY CENTER",
            "state": "KS",
            "postal_code": "674322908",
            "telephone_number": "785-632-3115",
            "fax_number": "785-632-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 LINCOLN AVE",
            "city": "CLAY CENTER",
            "state": "KS",
            "postal_code": "674322908",
            "telephone_number": "785-632-3115",
            "fax_number": "785-632-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEIMER DRUG CO., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "LINDY",
        "authorized_official_title_or_position": "DME BILLING ADMINISTRATOR",
        "authorized_official_telephone_number": "785-632-3115"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KS",
            "license": "207255",
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "KS",
            "license": "207255",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "KS",
            "license": "2-07255",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME NPI",
            "identifier": "1821119306",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100435190B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY NPI",
            "identifier": "1306840855",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PATTERSON HEALTH MART PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PATTERSON HEALTH MART PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clay Center, KS

All providers in Clay Center, KS · Durable Medical Equipment & Medical Supplies in Kansas

Sources for this page

Verify at the official NPI Registry.