Provider Demographics
NPI:1962499491
Name:CASPER PAYLESS DRUG
Entity Type:Organization
Organization Name:CASPER PAYLESS DRUG
Other - Org Name:BI-RITE HEALTHMART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:HARNAGEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:307-265-1914
Mailing Address - Street 1:428 S DURBIN ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2818
Mailing Address - Country:US
Mailing Address - Phone:307-265-1914
Mailing Address - Fax:307-472-3188
Practice Address - Street 1:428 S DURBIN ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2818
Practice Address - Country:US
Practice Address - Phone:307-265-1914
Practice Address - Fax:307-472-3188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY5200011332B00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY5200011OtherINSURANCE
WY5200011OtherINSURANCE