NPIMap

Organization Active NPI

Bethel Business LLC

  • Community/Retail Pharmacy
  • Colorado Springs, CO
National Provider Identifier
1821604646
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
BETHEL BUSINESS LLC
Practice address
1640 S Nevada Ave
Colorado Springs, CO 80905-2222
Phone
(719) 634-5541
Fax
(719) 634-0692
NPI assigned
Sep 17, 2020
Organization subpart
Yes
Parent organization
BETHEL BUSINESS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Authorized official

Name
Mrs. Shannon Belle Bethel, RPHNPI 1245480458
Title
Pharmacist/Co Owner
Phone
(719) 634-5541

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1640 S Nevada Ave
Colorado Springs, CO 80905-2222

Mailing address

1640 S Nevada Ave
Colorado Springs, CO 80905-2222
Phone (719) 634-5541

Other identifiers 1

IdentifierTypeStateIssuer
64108066MedicaidCO

Other names 1

  • Ivywild Pharmacy Doing business as

National Provider Directory

National Provider Directory
Part of
Bethel Business LLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600300800000",
    "number": "1821604646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 S NEVADA AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809052222",
            "telephone_number": "719-634-5541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 S NEVADA AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809052222",
            "telephone_number": "719-634-5541",
            "fax_number": "719-634-0692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL BUSINESS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BETHEL BUSINESS LLC",
        "enumeration_date": "2020-09-17",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-15",
        "status": "A",
        "authorized_official_last_name": "BETHEL",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "BELLE",
        "authorized_official_title_or_position": "PHARMACIST/CO OWNER",
        "authorized_official_telephone_number": "719-634-5541",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64108066",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ivywild Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.