NPIMap

Organization Active NPI

Thayer County Memorial Hospital

Doing business as Thayer County Pharmacy

  • Community/Retail Pharmacy
  • Hebron, NE
National Provider Identifier
1992302236
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
THAYER COUNTY MEMORIAL HOSPITAL
Doing business as
Thayer County Pharmacy
Practice address
428 Lincoln Ave
Hebron, NE 68370-1526
Phone
(402) 768-6319
Fax
(402) 768-6321
NPI assigned
Oct 8, 2020
Last updated
Dec 17, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
THAYER COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Authorized official

Name
Brian Rokusek
Title
Ceo
Phone
(402) 768-6041

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

428 Lincoln Ave
Hebron, NE 68370-1526

Mailing address

120 Park Ave
Hebron, NE 68370-2019
Phone (402) 768-6041

Other names 1

  • THAYER COUNTY PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201223002047 NE Part B Supplier - Pharmacy 3577559145 Practice locations: Hebron, NE
O20210119002520 NE DME Supplier - Pharmacy 3577559145 Practice locations: Hebron, NE

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Thayer County Pharmacy428 Lincoln Ave, Hebron, NE 68370-1526(402) 768-6319 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Canes and/or Crutches|Walkers|Orthoses: Off-The-Shelf|Enteral Nutrients|Nebulizer Equipment and/or… Accepts assignmentParticipating since Jan 1, 1992

National Provider Directory

National Provider Directory
Tax ID family
Thayer County Memorial7 organizations share this tax ID, including this one
Part of
Thayer County Memorial

Other organizations with this tax ID 6

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1992302236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PARK AVE",
            "city": "HEBRON",
            "state": "NE",
            "postal_code": "683702019",
            "telephone_number": "402-768-6041",
            "fax_number": "402-768-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 LINCOLN AVE",
            "city": "HEBRON",
            "state": "NE",
            "postal_code": "683701526",
            "telephone_number": "402-768-6319",
            "fax_number": "402-768-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THAYER COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THAYER COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2020-10-08",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "ROKUSEK",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-768-6041"
    },
    "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THAYER COUNTY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THAYER COUNTY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hebron, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.