Consultant Pharmacists Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

507 Issued in IA

Legal business name

CONSULTANT PHARMACISTS INC

Practice address

714 Illinois Street
Sidney, IA 51652

Phone

(712) 374-2513

Fax

(712) 374-3171

NPI assigned

Feb 7, 2007

Last updated

Feb 12, 2018By 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

Mrs. Angela Ettleman, CPHT

Title

Owner

Phone

(712) 374-2513

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518393600000",
    "number": "1972643914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 ILLINOIS STREET",
            "address_2": "PO BOX 360",
            "city": "SIDNEY",
            "state": "IA",
            "postal_code": "51652",
            "telephone_number": "712-374-2513",
            "fax_number": "712-374-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 ILLINOIS STREET",
            "city": "SIDNEY",
            "state": "IA",
            "postal_code": "51652",
            "telephone_number": "712-374-2513",
            "fax_number": "712-374-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSULTANT PHARMACISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2018-02-12",
        "status": "A",
        "authorized_official_last_name": "ETTLEMAN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-374-2513",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPHT"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0073288",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.