Active NPI
Bax Inc
Doing business as Fontanelle Drug
- Community/Retail Pharmacy
- Fontanelle, IA
National Provider Identifier
1992877518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 654
- Legal business name
- BAX INC
- Doing business as
- Fontanelle Drug
- Practice address
- 401 Washington St
Fontanelle, IA 50846-9900 - Phone
- (641) 745-3221
- Fax
- (641) 745-3221
- NPI assigned
- Nov 15, 2006
- Last updated
- Jan 17, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kaye Bax, RPH
- Title
- Pres
- Phone
- (641) 745-2008
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | NU | ||
| Community/Retail Pharmacy | 3336C0003X | 654 | IA | Primary |
| Long Term Care Pharmacy | 3336L0003X | NU |
Addresses
Primary practice location
401 Washington St
Fontanelle, IA 50846-9900
Mailing address
PO Box 366
401 Washington St
Fontanelle, IA 50846-0366
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2028010 | Other | PK | |
| 0137844 | Medicaid | IA |
Other names 1
- Fontanelle Drug
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1484611200000",
"number": "1992877518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 366",
"address_2": "401 WASHINGTON ST",
"city": "FONTANELLE",
"state": "IA",
"postal_code": "508460366",
"fax_number": "641-745-3221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 WASHINGTON ST",
"city": "FONTANELLE",
"state": "IA",
"postal_code": "508469900",
"telephone_number": "641-745-3221",
"fax_number": "641-745-3221"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BAX INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-15",
"last_updated": "2017-01-17",
"status": "A",
"authorized_official_last_name": "BAX",
"authorized_official_first_name": "KAYE",
"authorized_official_title_or_position": "PRES",
"authorized_official_telephone_number": "641-745-2008",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "IA",
"license": "654",
"primary": true
},
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2028010",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0137844",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Fontanelle Drug",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fontanelle, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.