Alan W Andersen, BS PHARM

Primary specialty

PharmacistTaxonomy code 183500000X

License

3898 Issued in NV

Practice address

898 Tanager St
In Care of Village Compounding Pharmacy
Incline Village, NV 89451

Phone

(775) 831-1133

Fax

(775) 831-2228

NPI assigned

Jun 16, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mr. Alan W Andersen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science, Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Village Pharmacy Inc

  • Community/Retail Pharmacy
  • Incline Village, NV
  • NPI 1114969649
  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193184000000",
    "number": "1992700819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3498",
            "city": "INCLINE VILLAGE",
            "state": "NV",
            "postal_code": "894503498",
            "telephone_number": "775-833-3060",
            "fax_number": "775-831-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "898 TANAGER ST",
            "address_2": "IN CARE OF VILLAGE COMPOUNDING PHARMACY",
            "city": "INCLINE VILLAGE",
            "state": "NV",
            "postal_code": "89451",
            "telephone_number": "775-831-1133",
            "fax_number": "775-831-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "ALAN",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "BS PHARM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2007-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "3898",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "24992",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "8194",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALAN",
            "last_name": "ANDERSEN",
            "middle_name": "W",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rodger Samuel Agre, M.D.
• Emily K. Allina, NP
• Aspire Insight Therapy
• Susan Ann Birch, DC
• Rachel Bowdle
• Kelly Elizabeth Brennan, MS, RD, LD
• Elisabeth Helen Brown, BAPPSC, MED

• All providers in Incline Village, NV
• Pharmacist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; 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.