SCOTTS PHARMACY J 404
NPI 1659576395
Pharmacy - Community/Retail Pharmacy in Fort Wayne, IN
NPI Status: Active since June 20, 2007
Contact Information
5300 DECATUR RD
FORT WAYNE, IN
ZIP 46806
Phone: (260) 458-0840
Fax: (260) 458-9302
- Organization
- Pharmacy
- Community/Retail Pharmacy
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 15D1021823
- CLIA Cert. Type: Other
- CLIA Exp. Date: 02-01-2026
About SCOTTS PHARMACY J 404
This page provides the complete NPI Profile along with additional information for Scotts Pharmacy J 404, a provider established in Fort Wayne, Indiana operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1659576395 assigned on June 2007. The practitioner's primary taxonomy code is 3336C0003X with license number 60006086A (IN). The provider is registered as an organization and their NPI record was last updated 16 years ago. The provider's is doing business as Scotts Pharmacy J 404. The authorized official of this NPI record is Matt Mineer Cpht (Interface Manager)
- NPI
- 1659576395
- Provider Legal Name
- KROGER LIMITED PARTNERSHIP I
- Other Organization Name
- SCOTTS PHARMACY J 404
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 5300 DECATUR RD FORT WAYNE, IN 46806
- Location Phone
- (260) 458-0840
- Location Fax
- (260) 458-9302
- Mailing Address
- 5960 CASTLEWAY WEST DR INDIANAPOLIS, IN 46250
- Mailing Phone
- (317) 579-8434
- Mailing Fax
- (260) 458-9302
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-20-2007
- Last Update Date
- 06-24-2009
- Code Navigator
Scotts Pharmacy J 404 is a medicare supplier with PTAN 20598899 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: Immunosuppressive Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or 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.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy Community/Retail Pharmacy
- Taxonomy Code
- 3336C0003X
- Type
- Suppliers
- License No.
- 60006086A
- License State
- IN
- Taxonomy Description
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1561542 | OTHER (01) | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| P00637372 | MEDICARE PIN (08) | ||
| 200872420A | MEDICAID (05) | IN | |
| 1193770678 | MEDICARE NSC (07) | ||
| 256660 | MEDICARE PIN (08) |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20598899
- Accepts Medicare Assignment
- YES
- Specialities List
- Pharmacy, Grocery Store.
- Competitive Bidding
- NO
Supplies List
- Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
- 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
- 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
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 this NPI number is:
- CLIA Number
- 15D1021823
- Facility Type
- Other
- Certificate Effective Date
- February 02, 2024
- Certificate Expiration Date
- February 01, 2026
- Laboratory Director
- LESLIE LAKE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Scotts Pharmacy J 404 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.
Reviews for SCOTTS PHARMACY J 404
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Validation Check Digit Calculation
The following table explains the step by step 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. | |||||||||
| 1 | 6 | 5 | 9 | 5 | 7 | 6 | 3 | 9 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 10 | 9 | 10 | 7 | 12 | 3 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 1 + 0 + 9 + 1 + 0 + 7 + 1 + 2 + 3 + 1 + 8 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1659576395 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1659576395, enumerated in the NPI registry as an "organization" on June 20, 2007
The provider is located at 5300 Decatur Rd Fort Wayne, In 46806 and the phone number is (260) 458-0840
This medical organization specializes in Pharmacy with taxonomy code 3336C0003X with a focus in Community/Retail Pharmacy
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 15D1021823 for a "other" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued 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..
This NPI record was last updated on June 20, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.