Provider Demographics
NPI:1588892095
Name:HOSPITAL PHARMACY INC
Entity type:Organization
Organization Name:HOSPITAL PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORPORATE SECRETARY / PIC
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM-D/RPH
Authorized Official - Phone:307-673-3188
Mailing Address - Street 1:1333 W 5TH ST STE 107
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-2752
Mailing Address - Country:US
Mailing Address - Phone:307-673-3188
Mailing Address - Fax:307-673-3190
Practice Address - Street 1:1333 W 5TH ST
Practice Address - Street 2:SUITE 107
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-2752
Practice Address - Country:US
Practice Address - Phone:307-673-3188
Practice Address - Fax:307-673-3190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-24
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
291U00000X, 332B00000X, 3336L0003X, 3336C0003X
WYR10055333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No291U00000XLaboratoriesClinical Medical Laboratory
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026829700Medicaid
WY127851701Medicaid
MT7145671Medicaid
SD8535180Medicaid
2120746OtherPK