Organization Active NPI

Overton Pharmacy LLC

Doing business as Overton Pharmacy

  • Community/Retail Pharmacy
  • Overton, TX
National Provider Identifier
1013230234
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
26857 Issued in TX
Legal business name
OVERTON PHARMACY LLC
Doing business as
Overton Pharmacy
Practice address
104 W Henderson St
Overton, TX 75684-1613
Phone
(903) 834-0154
Fax
(903) 834-0156
NPI assigned
Mar 2, 2010
Last updated
Jun 6, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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

Authorized official

Name
Abbi Splawn, PHARMDNPI 1144622366
Title
Owner
Phone
(903) 834-0154

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Community/Retail Pharmacy 3336C0003X 26857 TX Primary

Addresses

Primary practice location

104 W Henderson St
Overton, TX 75684-1613

Mailing address

104 W Henderson St
Overton, TX 75684-1613
Phone (903) 834-0154

Other identifiers 1

IdentifierTypeStateIssuer
2124308OtherPK

Other names 1

  • Overton Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140116000578 TX DME Supplier - Pharmacy 0547498776 Practice locations: Overton, TX
O20140911001679 TX Part B Supplier - Mass Immunization (Roster Biller Only) 0547498776 Practice locations: Overton, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Overton Pharmacy LLC104 W Henderson St, Overton, TX 75684-1613(903) 834-0154 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Orthoses: Off-The-Shelf|Ostomy Supplies|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Accepts assignmentParticipating since Nov 5, 2013

National Provider Directory

National Provider Directory

Locations

104 W Henderson St
Overton, TX 75684
Phone (903) 834-0154

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559779200000",
    "number": "1013230234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W HENDERSON ST",
            "city": "OVERTON",
            "state": "TX",
            "postal_code": "756841613",
            "telephone_number": "903-834-0154",
            "fax_number": "903-834-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W HENDERSON ST",
            "city": "OVERTON",
            "state": "TX",
            "postal_code": "756841613",
            "telephone_number": "903-834-0154",
            "fax_number": "903-834-0156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVERTON PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-02",
        "last_updated": "2019-06-06",
        "status": "A",
        "authorized_official_last_name": "SPLAWN",
        "authorized_official_first_name": "ABBI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-834-0154",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "26857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2124308",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Overton Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Overton Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Overton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.