NPIMap

Organization Active NPI

Pancho Independent Pharmacy, Inc

Doing business as Rosedale pharmacy

  • Community/Retail Pharmacy
  • Fort Worth, TX
National Provider Identifier
1043534795
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
26859 Issued in TX
Legal business name
PANCHO INDEPENDENT PHARMACY, INC
Doing business as
Rosedale pharmacy
Practice address
900 W Rosedale St
Ste B
Fort Worth, TX 76104-4537
Phone
(817) 870-1900
Fax
(817) 870-1908
NPI assigned
Mar 24, 2010
Last updated
Aug 4, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
PANCHO INDEPENDENT PHARMACYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Authorized official

Name
Dr. Francis Etengani Njie, RPHNPI 1982530416
Title
Manager/Pharmacist
Phone
(713) 253-5115

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 26859 TX Primary

Addresses

Primary practice location

900 W Rosedale St
Ste B
Fort Worth, TX 76104-4537

Mailing address

900 W Rosedale St
Ste B
Fort Worth, TX 76104-4537
Phone (817) 870-1900

Other names 1

  • Rosedale pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pancho Independent Pharmacy Inc5 organizations share this tax ID, including this one
Part of
Pancho Independent Pharmacy Inc

Other organizations with this tax ID 4

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

Locations

900 W Rosedale St
Ste B
Fort Worth, TX 76104
Phone (817) 870-1900

Practitioners & affiliated clinicians

Practitioners 1

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": "1269388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438646400000",
    "number": "1043534795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W ROSEDALE ST",
            "address_2": "STE B",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044537",
            "telephone_number": "817-870-1900",
            "fax_number": "817-870-1908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W ROSEDALE ST",
            "address_2": "STE B",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044537",
            "telephone_number": "817-870-1900",
            "fax_number": "817-870-1908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANCHO INDEPENDENT PHARMACY, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PANCHO INDEPENDENT PHARMACY",
        "enumeration_date": "2010-03-24",
        "last_updated": "2015-08-04",
        "status": "A",
        "authorized_official_last_name": "NJIE",
        "authorized_official_first_name": "FRANCIS",
        "authorized_official_middle_name": "ETENGANI",
        "authorized_official_title_or_position": "MANAGER/PHARMACIST",
        "authorized_official_telephone_number": "713-253-5115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "26859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rosedale pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; 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.