Hillside Pharmacy

Primary specialty

PharmacistTaxonomy code 183500000X

License

5201013 Issued in WY

Legal business name

HILLSIDE PHARMACY

Practice address

224 Main Street
Sundance, WY 82729-0547

Phone

(307) 283-3883

Fax

(307) 283-3884

NPI assigned

Oct 23, 2006

Last updated

Jun 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Virgil Virchow

Title

Pharmacist/Owner

Phone

(307) 283-3883

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1881777696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "SUNDANCE",
            "state": "WY",
            "postal_code": "827290547",
            "telephone_number": "307-283-3883",
            "fax_number": "307-283-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 MAIN STREET",
            "city": "SUNDANCE",
            "state": "WY",
            "postal_code": "827290547",
            "telephone_number": "307-283-3883",
            "fax_number": "307-283-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSIDE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "VIRCHOW",
        "authorized_official_first_name": "VIRGIL",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "307-283-3883",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WY",
            "license": "5201013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106755900",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Sundance, WY
• Providers in Sundance, WY by specialty
• Pharmacist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.