KING SOOPERS PHARMACY (DILLON COMPANIES LLC) NPI 1255369344

Pharmacy (Community/Retail Pharmacy) in Greenwood Village, CO

NPI 1255369344 Organization Pharmacy Community/Retail Pharmacy Medicare Supplier Accepts Medicare Approved Payment CLIA Number 06D2017539 CLIA Certificate of Waiver

NPI Profile for KING SOOPERS PHARMACY (DILLON COMPANIES LLC)

King Soopers Pharmacy (dillon Companies Llc) is a provider established in Greenwood Village, Colorado specializing in pharmacy (community/retail pharmacy) . The NPI number of King Soopers Pharmacy (dillon Companies Llc) is 1255369344 and was assigned on June 2006. The practitioner's primary taxonomy code is 3336C0003X with license number 1550000002 (CO). The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as King Soopers Pharmacy. The authorized official of this NPI record is Jessie Warman (Manager Of Pharmacy Licensing)

King Soopers Pharmacy is a medicare supplier with PTAN 0238530143 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Commodes, Urinals, Bedpans or Blood Glucose Monitors/Supplies (Non-Mail Order) or Canes and/or Crutches or Walkers or Ostomy Supplies or Urological Supplies or Enteral Nutrients or Enteral Equipment and/or Supplies or Nebulizer Equipment and/or Supplies or Surgical Dressings.

The CLIA number of King Soopers Pharmacy is 06D2017539 registered as a "pharmacy" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to King Soopers Pharmacy to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1255369344

Provider NameKING SOOPERS PHARMACY (DILLON COMPANIES LLC)
Provider Location Address4910 S YOSEMITE ST GREENWOOD VILLAGE, CO 80111
Provider Mailing AddressPO BOX 842772 BOSTON, MA 02284
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameKING SOOPERS PHARMACY
Other Name TypeDoing Business As (3)
Enumeration Date06-29-2006
Last Update Date08-08-2018


Primary Taxonomy

Taxonomy Code3336C0003X
ClassificationPharmacy
TypeSuppliers
SpecializationCommunity/Retail Pharmacy
License No.1550000002
License StateCO
Taxonomy DescriptionA pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Business Address

KING SOOPERS PHARMACY
4910 S YOSEMITE ST
GREENWOOD VILLAGE, CO
ZIP 80111
Phone: (303) 773-2390
Fax: (303) 741-2563

Get Directions


Mailing Address

KING SOOPERS PHARMACY
PO BOX 842772
BOSTON, MA
ZIP 02284
Phone: (513) 762-1019
Fax: (513) 762-1092



Authorized Official

Authorized Official Name JESSIE WARMAN
Authorized Official TitleMANAGER OF PHARMACY LICENSING
Authorized Official Phone(513) 762-1019

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN0238530143
Accepts Medicare AssignmentYES
Specialities ListPharmacy, Grocery Store.
Supplies List
  • Commodes, Urinals, Bedpans - Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
  • Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
  • Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
  • Walkers - Standard Walkers, Wheeled Walkers, Folding Walker
  • Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
  • Urological Supplies - Catheters, Urinary collection devices
  • Enteral Nutrients - Enteral formula
  • Enteral Equipment and/or Supplies - Enteral infusion pumps, enteral nutrition supply kits
  • Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
  • Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
Competitive BiddingNO

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1255369344 is:

CLIA Number06D2017539
Facility TypePHARMACY
Certificate TypeCertificate of Waiver

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1332B00000XSuppliersDurable Medical Equipment & Medical SuppliesNo

Taxonomy Description: a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

2333600000XSuppliersPharmacyNo

Taxonomy Description: a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
03485679MEDICAID (05)CO
2001503OTHER (01)PK

NPI Validation Check Digit Calculation


The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1255369344
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
22105661838
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 0 + 5 + 6 + 6 + 1 + 8 + 3 + 8 + 24 = 66
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 66 = 44

The NPI number 1255369344 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 6 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1932542982 FATEMEH BIGHASH
Individual
Pharmacist4910 S YOSEMITE ST
GREENWOOD VILLAGE, CO 80111
(303) 773-2390
1386087120 CHANEL NGUYEN RPH
Individual
Pharmacist4910 S YOSEMITE ST
GREENWOOD VILLAGE, CO 80111
(303) 773-2390
1003005505MRS. SHELLEY RENAE HAMMEN RPH
Individual
Pharmacist4910 S YOSEMITE ST
GREENWOOD VILLAGE, CO 80111
(303) 773-2390
1447669049 ALICIA GARCIA PHARM.D.
Individual
Pharmacist4910 S YOSEMITE ST
GREENWOOD VILLAGE, CO 80111
(303) 773-2390
1871962464 YEVGENIYA LVOVSKIY SCHERBAK PHARMD
Individual
Pharmacist4910 S YOSEMITE ST
GREENWOOD VILLAGE, CO 80111
(303) 773-2390
1306390687 TRACEY LAESSIG PHARM D
Individual
Pharmacist4910 S YOSEMITE ST
GREENWOOD VILLAGE, CO 80111
(303) 773-2390

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
King Soopers Pharmacy is registered as an entity type code: 2. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.