Active NPI
Amanuel Adane, PHARMD
- Pharmacist
- Desoto, TX
National Provider Identifier
1003365545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 59451
- Practice address
- 108 W Parkerville Rd
Desoto, TX 75115-8074 - Phone
- (469) 643-5017
- Fax
- (469) 643-5014
- NPI assigned
- Sep 26, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 59451 | TX | Primary |
Addresses
Primary practice location
108 W Parkerville Rd
Desoto, TX 75115-8074
Mailing address
108 W Parkerville Rd
Desoto, TX 75115-8074
Phone (214) 830-3587
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59451 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores Texas LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Desoto, TX
- NPI 1396148193
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474934400000",
"number": "1003365545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 W PARKERVILLE RD",
"city": "DESOTO",
"state": "TX",
"postal_code": "751158074",
"telephone_number": "214-830-3587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 W PARKERVILLE RD",
"city": "DESOTO",
"state": "TX",
"postal_code": "751158074",
"telephone_number": "469-643-5017",
"fax_number": "469-643-5014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADANE",
"first_name": "AMANUEL",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-26",
"last_updated": "2016-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "59451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Desoto, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.