NPIMap

Organization Active NPI

Pharm Nacogdoches Acquisition LLC

  • Long Term Care Pharmacy
  • Nacogdoches, TX
National Provider Identifier
1013694264
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
PHARM NACOGDOCHES ACQUISITION LLC
Practice address
212 North St
Nacogdoches, TX 75961-5260
Phone
(936) 569-6430
NPI assigned
Jun 29, 2023
Organization subpart
Yes
Parent organization
PHARM NACOGDOCHES ACQUISITION LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Authorized official

Name
Matthew Finn
Title
Officer
Phone
(469) 261-3048

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

212 North St
Nacogdoches, TX 75961-5260

Mailing address

212 North St
Nacogdoches, TX 75961-5260

Other names 1

  • Medicine Shoppe LTC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pharm Nacogdoches Acquisition LLC3 organizations share this tax ID, including this one
Part of
Pharm Nacogdoches Acquisition LLC

Other organizations with this tax ID 2

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

Locations

212 North St
Nacogdoches, TX 75961
Phone (936) 569-6430

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687996800000",
    "number": "1013694264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 NORTH ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759615260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 NORTH ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759615260",
            "telephone_number": "936-569-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARM NACOGDOCHES ACQUISITION LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHARM NACOGDOCHES ACQUISITION LLC",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A",
        "authorized_official_last_name": "FINN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "469-261-3048"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicine Shoppe LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nacogdoches, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.