Shatto Drug Inc

Primary specialty

PharmacistTaxonomy code 183500000X

License

1995 Issued in WY

Legal business name

SHATTO DRUG INC

Doing business as

Shatto's Frontier Drug

Practice address

1202 E Richards St
Douglas, WY 82633-2934

Phone

(307) 358-5077

Fax

(307) 358-6301

NPI assigned

Aug 2, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Tanner B Shatto

Title

Co-Owner

Phone

(307) 358-5077

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Shatto's Frontier Drug Doing business as

Medicare fee-for-service enrollment

Enrolled in WY2 enrollments

Enrollment records 2

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

Locations

Practitioners 3

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.

• Kirsten Brown

  • Pharmacist
  • Douglas, WY
  • NPI 1750839767
  NPD (past)
• Calee Jo Davidson, PHARMD

  • Pharmacist
  • Douglas, WY
  • NPI 1851277503
  NPD (past)
• Angela M Wilde, PHARMD

  • Pharmacist
  • Douglas, WY
  • NPI 1396158457
  NPD (past)

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1871594895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 705",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826330705",
            "telephone_number": "307-358-5077",
            "fax_number": "307-358-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 E RICHARDS ST",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826332934",
            "telephone_number": "307-358-5077",
            "fax_number": "307-358-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHATTO DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2023-03-07",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "SHATTO",
        "authorized_official_first_name": "TANNER",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "307-358-5077",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "WY",
            "license": "1995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106589100",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106589101",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "5201431",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shatto's Frontier Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kevin Andrew Shumway, PHARMD
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• Pharmacist in Douglas, WY
• Providers in Douglas, WY by specialty
• Pharmacist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.