NPIMap

Organization Active NPI

Dutch Mill Corporation

Doing business as Dutch Mill Clinic Phcy

  • Community/Retail Pharmacy
  • Orange City, IA
National Provider Identifier
1972531721
Registry record updated Oct 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1290 Issued in IA
Legal business name
DUTCH MILL CORPORATION
Doing business as
Dutch Mill Clinic Phcy
Practice address
1000 Lincoln Cir SE
Orange City, IA 51041-1836
Phone
(712) 737-5347
Fax
(712) 737-5348
NPI assigned
Jun 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2011

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

Authorized official

Name
Brent Plender
Title
Co-Owner
Phone
(712) 737-4844

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 1290 IA Primary

Addresses

Primary practice location

1000 Lincoln Cir SE
Orange City, IA 51041-1836

Mailing address

1000 Lincoln Cir SE
Orange City, IA 51041-1836
Phone (712) 737-5347

Other identifiers 2

IdentifierTypeStateIssuer
0488445MedicaidIA
1622530OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • DUTCH MILL CLINIC PHCY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dutch Mill Corporation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318896000000",
    "number": "1972531721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LINCOLN CIR SE",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510411836",
            "telephone_number": "712-737-5347",
            "fax_number": "712-737-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LINCOLN CIR SE",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510411836",
            "telephone_number": "712-737-5347",
            "fax_number": "712-737-5348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUTCH MILL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2011-10-18",
        "status": "A",
        "authorized_official_last_name": "PLENDER",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "712-737-4844"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "1290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0488445",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1622530",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DUTCH MILL CLINIC PHCY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orange City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; 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.