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SERGEANT BLUFF PHARMACY
NPI 1275602518
Pharmacy - Community/Retail Pharmacy in Sergeant Bluff, IA

Active since November 08, 2006CLIA 16D2324388 · Waiver
105 GAUL DR STE A, SERGEANT BLUFF, IA 51054(712) 943-1494(712) 943-1496 Get Directions Write a Review

NPPES record last updated: January 28, 2021. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Jan 28, 2021, Jul 19, 2018, Jun 1, 2017 and 1 more (4 updates tracked since 2017).

About Sergeant Bluff Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SERGEANT BLUFF PHARMACY (NPI 1275602518) is a healthcare organization registered as a community/retail pharmacy in Sergeant Bluff, Iowa and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through May 21, 2027 and lists Stacey A Jackson, Owner, as its authorized official.

NPPES Registry Identity

NPI1275602518
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSERGEANT BLUFF PHARMACY INC
Location Address105 GAUL DR STE ASergeant Bluff, IA 51054-8963
Mailing Address105 Gaul Dr Ste ASergeant Bluff, IA 51054-8963 · (712) 943-1494 · Fax (712) 943-1496
Phone(712) 943-1494
Fax(712) 943-1496
Organization SubpartNo
Authorized OfficialStacey A JacksonOwner · (712) 943-1494
Enumeration DateNovember 8, 2006
Last NPPES UpdateJanuary 28, 20214 updates tracked since enumeration
NPPES CertifiedJanuary 28, 2021
✔ NPI 1275602518 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in IA · 1304
Definition
A 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.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
105 GAUL DR STE A, Sergeant Bluff, IA 51054
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Other Names 1

Doing Business AsSergeant Bluff Pharmacy

Other Identifiers 3

Other2030418Pk
Medicaid10025475600NE
Medicaid0736173IA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 16D2324388

Sergeant Bluff Pharmacy · Sergeant Bluff, IA
Active · expires May 21, 2027
CLIA Number16D2324388
Laboratory TypePharmacy
Certificate Effective DateMay 22, 2025
Certificate Expiration DateMay 21, 2027
Laboratory DirectorStacey A. Jackson
Laboratory Phone(712) 943-1494
Laboratory LocationSergeant Bluff Pharmacy105 Gaul Dr Ste A, Sergeant Bluff, IA 51054
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
93 services93 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
88 services88 patients

Medical Equipment Supplier Medicare DMEPOS 8

Medicare supplier enrollment and the product categories Sergeant Bluff Pharmacy carries, from the Medicare DMEPOS supplier directory.

Sergeant Bluff Pharmacy

DMEPOS supplier · Sergeant Bluff, IAOperated by Sergeant Bluff Pharmacy Inc
⋮

Does not accept Medicare assignment

Sergeant Bluff Pharmacy has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20571149
Medicare Participant SinceDecember 15, 2006
Supplier Location105 Gaul Dr Ste ASergeant Bluff, IA 51054
Phone(712) 943-1494
Supplier Specialties
Pharmacy

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LISA MARIE LAUTERS RPH
Pharmacist
105 GAUL DR STE A
SERGEANT BLUFF, IA 51054
Woodbury County (712) 943-1494
BEVERLY SCHUSTER
Pharmacist
105 GAUL DR STE A
SERGEANT BLUFF, IA 51054
Woodbury County (712) 943-1494
DR. STACEY A JACKSON PHARMD
Pharmacist
105 GAUL DR STE A
SERGEANT BLUFF, IA 51054
Woodbury County (712) 943-1494

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sergeant Bluff Pharmacy Inc's NPI number?

The NPI number for Sergeant Bluff Pharmacy Inc is 1275602518. It was assigned to this organization in the NPPES registry on November 8, 2006. The provider is doing business as Sergeant Bluff Pharmacy.

Where is Sergeant Bluff Pharmacy Inc located?

Sergeant Bluff Pharmacy Inc is located at 105 Gaul Dr Ste A, Sergeant Bluff, IA 51054. The listed phone number is (712) 943-1494.

What is Sergeant Bluff Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Sergeant Bluff Pharmacy Inc accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Sergeant Bluff Pharmacy does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Sergeant Bluff Pharmacy Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 16D2324388) is associated with this NPI, valid through May 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Sergeant Bluff Pharmacy Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 48 other insurers list Sergeant Bluff Pharmacy Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sergeant Bluff Pharmacy Inc was last updated on January 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.