Thomas C Ryan

Primary specialty

PharmacyTaxonomy code 333600000X

License

36 Issued in IA

Legal business name

THOMAS C RYAN

Doing business as

Peterson Pharmacy

Practice address

104 E Washington St
Marengo, IA 52301-1545

Phone

(319) 642-3312

Fax

(319) 741-6011

NPI assigned

Jan 10, 2006

Last updated

Dec 13, 2016By 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

Thomas Ryan, R PH

Title

Owner/Pic

Phone

(319) 642-3312

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• PETERSON PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481587200000",
    "number": "1992784870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E WASHINGTON ST",
            "city": "MARENGO",
            "state": "IA",
            "postal_code": "523011545",
            "telephone_number": "319-642-3312",
            "fax_number": "319-741-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E WASHINGTON ST",
            "city": "MARENGO",
            "state": "IA",
            "postal_code": "523011545",
            "telephone_number": "319-642-3312",
            "fax_number": "319-741-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS C RYAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-10",
        "last_updated": "2016-12-13",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER/PIC",
        "authorized_official_telephone_number": "319-642-3312",
        "authorized_official_credential": "R PH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IA",
            "license": "36",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992784870",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2028364",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PETERSON PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Allen Siebrecht, D.P.M.
• State University of Iowa (Marengo Medical Center)
• Switzer Counseling Services, LLC
• Kelli Sue Switzer, LISW, RPT/S
• Barbara Jean Taylor, MS, RD, LD
• Laura Varo, MS CCC-SLP
• Heidi M Wauters, ARNP
• Karen Frances Wayson-Kisling, NP-C
• Tiffany Willis, MD
• Wilson Counseling Services, LLC

• Pharmacy in Marengo, IA
• Providers in Marengo, IA by specialty
• Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.