NPIMap

Organization Active NPI

Pharmedium Services LLC

  • Compounding Pharmacy
  • Sugar Land, TX
National Provider Identifier
1013178656
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Compounding PharmacyTaxonomy code 3336C0004X
License
22931 Issued in TX
Legal business name
PHARMEDIUM SERVICES LLC
Practice address
12620 W Airport Blvd
Ste 130
Sugar Land, TX 77478-6199
Phone
(281) 491-1900
Fax
(866) 380-6918
NPI assigned
Jun 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Richard Dillow, RPH
Title
Phcy Mang
Phone
(281) 491-1900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Compounding Pharmacy 3336C0004X 22931 TX Primary

Addresses

Primary practice location

12620 W Airport Blvd
Ste 130
Sugar Land, TX 77478-6199

Mailing address

12620 W Airport Blvd
Ste 130
Sugar Land, TX 77478-6199

Other identifiers 1

IdentifierTypeStateIssuer
4548484OtherOTHER ID NUMBER

Other names 1

  • PHARMEDIUM SERVICES LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pharmedium Services LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12620 W Airport Blvd
Ste 130
Sugar Land, TX 77478
Phone (281) 491-1900

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1013178656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12620 W AIRPORT BLVD",
            "address_2": "STE 130",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774786199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12620 W AIRPORT BLVD",
            "address_2": "STE 130",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774786199",
            "telephone_number": "281-491-1900",
            "fax_number": "866-380-6918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMEDIUM SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-17",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "DILLOW",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PHCY MANG",
        "authorized_official_telephone_number": "281-491-1900",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "TX",
            "license": "22931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "4548484",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHARMEDIUM SERVICES LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.