NPIMap

Organization Active NPI

Pyramid Pharmacy, LLC

Doing business as Pyramid Pharmacy

  • Long Term Care Pharmacy
  • Jefferson City, MO
National Provider Identifier
1881057677
Registry record updated Mar 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
2010035928 Issued in MO
Legal business name
PYRAMID PHARMACY, LLC
Doing business as
Pyramid Pharmacy
Practice address
3501 W Truman Blvd
Suite H
Jefferson City, MO 65109-0514
Phone
(573) 556-5551
Fax
(573) 556-5552
NPI assigned
Mar 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2016

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

Authorized official

Name
Kimberly Ann RobertsNPI 1578361218
Title
Pharmacist in Charge
Phone
(573) 556-5551

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
Long Term Care Pharmacy 3336L0003X 2010035928 MO Primary

Addresses

Primary practice location

3501 W Truman Blvd
Suite H
Jefferson City, MO 65109-0514

Mailing address

3501 W Truman Blvd
Suite H
Jefferson City, MO 65109-0514
Phone (573) 556-5551

Other identifiers 1

IdentifierTypeStateIssuer
606488302MedicaidMO

Other names 1

  • Pyramid Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Roberts Drug Storellc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

3501 W Truman Blvd
Ste H
Jefferson Cty, MO 65109
Phone (573) 556-5551

Practitioners & affiliated clinicians

Practitioners 1

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": "1459296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459296000000",
    "number": "1881057677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 W TRUMAN BLVD",
            "address_2": "SUITE H",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651090514",
            "telephone_number": "573-556-5551",
            "fax_number": "573-556-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 W TRUMAN BLVD",
            "address_2": "SUITE H",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651090514",
            "telephone_number": "573-556-5551",
            "fax_number": "573-556-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PYRAMID PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-30",
        "last_updated": "2016-03-30",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "573-556-5551"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MO",
            "license": "2010035928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606488302",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pyramid Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; 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.