Organization Active NPI

K-Pack Pharmacy

  • Community/Retail Pharmacy
  • Green River, WY
National Provider Identifier
1851935688
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
K-PACK PHARMACY
Practice address
170 Commerce Dr Ste B
Green River, WY 82935-6156
Phone
(307) 875-6722
Fax
(307) 466-4181
NPI assigned
Nov 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Authorized official

Name
Dr. Alma Killpack, PHARM DNPI 1326485137
Title
Pic
Phone
(307) 871-9764

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

170 Commerce Dr Ste B
Green River, WY 82935-6156

Mailing address

170 Commerce Dr Ste B
Green River, WY 82935-6156
Phone (307) 875-6722

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200819003875 WY Part B Supplier - Pharmacy 7517383698 Practice locations: Green River, WY

National Provider Directory

National Provider Directory

Locations

170 Commerce Dr
Ste B
Green River, WY 82935
Phone (307) 875-6722

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671667200000",
    "number": "1851935688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 COMMERCE DR STE B",
            "city": "GREEN RIVER",
            "state": "WY",
            "postal_code": "829356156",
            "telephone_number": "307-875-6722",
            "fax_number": "307-466-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 COMMERCE DR STE B",
            "city": "GREEN RIVER",
            "state": "WY",
            "postal_code": "829356156",
            "telephone_number": "307-875-6722",
            "fax_number": "307-466-4181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K-PACK PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-05",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A",
        "authorized_official_last_name": "KILLPACK",
        "authorized_official_first_name": "ALMA",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "307-871-9764",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green River, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; 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.