NPIMap

Organization Active NPI

Pratt'S Rexall Drugs, Inc.

  • Durable Medical Equipment & Medical Supplies
  • New Haven, MO
National Provider Identifier
1912101031
Registry record updated Mar 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
129 Issued in MO
Legal business name
PRATT'S REXALL DRUGS, INC.
Practice address
100 Dwayne Von Berhen Dr
New Haven, MO 63068-3207
Phone
(573) 237-3321
Fax
(573) 237-2005
NPI assigned
Jun 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2009

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

Authorized official

Name
Mr. Craig N Willimann, R.PHNPI 1154341337
Title
Pharmacist
Phone
(573) 237-3321

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
Durable Medical Equipment & Medical Supplies 332B00000X 129 MO Primary

Addresses

Primary practice location

100 Dwayne Von Berhen Dr
New Haven, MO 63068-3207

Mailing address

100 Dwayne Von Berhen Dr
New Haven, MO 63068-3207
Phone (573) 237-3321

Other identifiers 1

IdentifierTypeStateIssuer
600447003MedicaidMO

Other names 1

  • Pratt's Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pratt'S Pharmacy2 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

100 Dwayne Von Berhen Dr
New Haven, MO 63068
Phone (573) 237-3321

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237420800000",
    "number": "1912101031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 DWAYNE VON BERHEN DR",
            "city": "NEW HAVEN",
            "state": "MO",
            "postal_code": "630683207",
            "telephone_number": "573-237-3321",
            "fax_number": "573-237-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DWAYNE VON BERHEN DR",
            "city": "NEW HAVEN",
            "state": "MO",
            "postal_code": "630683207",
            "telephone_number": "573-237-3321",
            "fax_number": "573-237-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRATT'S REXALL DRUGS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2009-03-19",
        "status": "A",
        "authorized_official_last_name": "WILLIMANN",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "573-237-3321",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": "129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600447003",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pratt's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Haven, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2009; 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.