NPIMap

Organization Active NPI

C R Pharmacy Service Inc

Doing business as CarePro Home Medical

  • Oxygen Equipment & Supplies (DME)
  • Cedar Rapids, IA
National Provider Identifier
1992755615
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
5641 Issued in IA
Legal business name
C R PHARMACY SERVICE INC
Doing business as
CarePro Home Medical
Practice address
402 10TH St SE
Suite 600
Cedar Rapids, IA 52403-2459
Phone
(319) 298-0953
Fax
(319) 298-0954
NPI assigned
May 11, 2006
Last updated
Jul 31, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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

Authorized official

Name
Mrs. Michelle M. Jensen
Title
Ceo
Phone
(319) 363-4554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X 5641 IA Primary

Addresses

Primary practice location

402 10TH St SE
Suite 600
Cedar Rapids, IA 52403-2459

Mailing address

402 10TH St SE
Suite 600
Cedar Rapids, IA 52403-2459
Phone (319) 298-0953

Other identifiers 1

IdentifierTypeStateIssuer
0159772MedicaidIA

Other names 1

  • CarePro Home Medical Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930000280 IA DME Supplier - Medical Supply CompanyDME Supplier - Oxygen & EquipmentDME Supplier - Orthotic PersonnelDME Supplier - Medical Supply Company With Respiratory Therapist 9234022260 Practice locations: Cedar Rapids, IA

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
C R Pharmacy Service Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

402 10th St SE
Ste 600
Cedar Rapids, IA 52403
Phone (319) 298-0953

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438300800000",
    "number": "1992755615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 10TH ST SE",
            "address_2": "SUITE 600",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032459",
            "telephone_number": "319-298-0953",
            "fax_number": "319-298-0954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 10TH ST SE",
            "address_2": "SUITE 600",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524032459",
            "telephone_number": "319-298-0953",
            "fax_number": "319-298-0954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C R PHARMACY SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2015-07-31",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "319-363-4554",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "IA",
            "license": "5641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0159772",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CarePro Home Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; 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.