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Enrollment ID O20200420001993 resolves to a single NPI record. Open the full profile for complete detail.

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NPI · 1699872416 · Active

Occuvax LLC

Pharmacy · Omaha, Nebraska

Active

NPI

1699872416

Enrollment ID

O20200420001993

Taxonomy

333600000X

Type

Part B Supplier - Mass Immunization (roster Biller Only)

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Medicare enrollment

This provider holds 25 Medicare enrollments on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.

Part B Supplier

O20100111000600Mass Immunization (Roster Biller Only)TN
O20200420001993Mass Immunization (Roster Biller Only)GA
O20200420002494Mass Immunization (Roster Biller Only)SC
O20200422002236Mass Immunization (Roster Biller Only)NC
O20200422002504Mass Immunization (Roster Biller Only)WV
O20200422002978Mass Immunization (Roster Biller Only)VA
O20200422003001Mass Immunization (Roster Biller Only)DE
O20200430002504Mass Immunization (Roster Biller Only)MO
O20200508000707Mass Immunization (Roster Biller Only)CO
O20200512002225Mass Immunization (Roster Biller Only)WY
O20200512002302Mass Immunization (Roster Biller Only)WA
O20200512002378Mass Immunization (Roster Biller Only)OR
O20200512002439Mass Immunization (Roster Biller Only)ID
O20200512002488Mass Immunization (Roster Biller Only)HI
O20200512002596Mass Immunization (Roster Biller Only)AZ
O20200513002204Mass Immunization (Roster Biller Only)MT
O20200513002240Mass Immunization (Roster Biller Only)AK
O20200515001876Mass Immunization (Roster Biller Only)CA
O20200527002793Mass Immunization (Roster Biller Only)UT
O20200527003271Mass Immunization (Roster Biller Only)NV
O20200603000113Mass Immunization (Roster Biller Only)VT
O20200603002710Mass Immunization (Roster Biller Only)NY
O20200604000381Mass Immunization (Roster Biller Only)CT
O20200604000462Mass Immunization (Roster Biller Only)NH
O20200604000566Mass Immunization (Roster Biller Only)ME

Source: CMS PECOS public enrollment file.

ReferenceAbout Medicare Enrollment IDs

A Medicare Enrollment ID (ENRLMT_ID) is a 15-character public identifier assigned by the CMS Provider Enrollment, Chain and Ownership System (PECOS) when a provider, supplier, or organisation enrols in Medicare. Each row reflects one enrolment record: a single NPI can hold multiple enrolments across provider types, states, or supplier categories. Data here is mirrored from the quarterly public PECOS enrolment file published on data.cms.gov.