NPIMap

Organization Active NPI

Cde LLC

Doing business as City Drug LTC

  • Long Term Care Pharmacy
  • Evanston, WY
National Provider Identifier
1881160190
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
CDE LLC
Doing business as
City Drug LTC
Practice address
131 10TH St
Evanston, WY 82930-3421
Phone
(307) 789-4000
NPI assigned
Oct 15, 2018
Last updated
Sep 28, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CDE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Authorized official

Name
Andrew CannonNPI 1255880704
Title
Managing Member
Phone
(307) 789-4000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

131 10TH St
Evanston, WY 82930-3421

Mailing address

131 10TH St
Evanston, WY 82930-3421
Phone (307) 789-4000

Other names 1

  • CITY DRUG LTC Doing business as

National Provider Directory

National Provider Directory
Part of
Cde 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, 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": "1539561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664323200000",
    "number": "1881160190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 10TH ST",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829303421",
            "telephone_number": "307-789-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 10TH ST",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829303421",
            "telephone_number": "307-789-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CDE, LLC",
        "enumeration_date": "2018-10-15",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "307-789-4000"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CITY DRUG LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evanston, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.