NPIMap

Organization Active NPI

Buena Vista Regional Medical Center

Doing business as Bvrmc Pharmacy

  • Community/Retail Pharmacy
  • Storm Lake, IA
National Provider Identifier
1821154220
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1056 Issued in IA
Legal business name
BUENA VISTA REGIONAL MEDICAL CENTER
Doing business as
Bvrmc Pharmacy
Practice address
620 Northwestern Dr
Pod 2
Storm Lake, IA 50588-2935
Phone
(712) 213-8065
Fax
(712) 213-1233
NPI assigned
Dec 29, 2006
Last updated
Jan 30, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
BUENA VISTA REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Authorized official

Name
Mr. Steven Rob Colerick
Title
Ceo
Phone
(712) 213-8600

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X 1056 IA
Clinic Pharmacy 3336C0002X 1056 IA
Community/Retail Pharmacy 3336C0003X 1056 IA Primary

Addresses

Primary practice location

620 Northwestern Dr
Pod 2
Storm Lake, IA 50588-2935

Mailing address

PO Box 309
Storm Lake, IA 50588-0309
Phone (712) 732-4030

Other identifiers 1

IdentifierTypeStateIssuer
1166108MedicaidIA

Other names 1

  • BVRMC PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170207000404 IA DME Supplier - Pharmacy 3476464421 Practice locations: Storm Lake, IA
O20181025002597 IA Part B Supplier - Mass Immunization (Roster Biller Only) 3476464421 Practice locations: Storm Lake, IA

Other NPIs with the same Medicare PAC ID 3

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Bvrmc Pharmacy620 Northwestern Dr, Storm Lake, IA 50588-2935(712) 213-8065 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Jan 1, 1994

National Provider Directory

National Provider Directory
Tax ID family
Buena Vista Hosp Ambula8 organizations share this tax ID, including this one
Part of
Buena Vista Hosp Ambula

Other organizations with this tax ID 7

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

Locations

114 S 20th St
Denison, IA 51442
Phone (712) 263-3114

736 Highway 37
Earling, IA 51530
Phone (712) 747-3301

607 Queen St
Fonda, IA 50540
Phone 51522444421259

2306 State St
Guthrie Ctr, IA 50115
Phone (641) 332-2204

620 Northwestern Dr
#1
Storm Lake, IA 50588
Phone (712) 732-4030

620 Northwestern Dr
#2
Storm Lake, IA 50588
Phone (712) 213-8065

620 Northwestern Dr
#3
Storm Lake, IA 50588
Phone (712) 732-4030

620 Northwestern Dr
#4
Storm Lake, IA 50588
Phone (712) 213-8050

620 Northwestern Dr
#G
Storm Lake, IA 50588
Phone (712) 749-5038

620 Northwestern Dr
#K
Storm Lake, IA 50588
Phone (712) 749-5038

Practitioners & affiliated clinicians

Practitioners 51

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 51

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1821154220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 309",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505880309",
            "telephone_number": "712-732-4030",
            "fax_number": "712-213-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 NORTHWESTERN DR",
            "address_2": "POD 2",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505882935",
            "telephone_number": "712-213-8065",
            "fax_number": "712-213-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUENA VISTA REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BUENA VISTA REGIONAL MEDICAL CENTER",
        "enumeration_date": "2006-12-29",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "COLERICK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "ROB",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "712-213-8600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IA",
            "license": "1056",
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "IA",
            "license": "1056",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "1056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1166108",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BVRMC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Storm Lake, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.