NPIMap

Organization Active NPI

Providerx of Midland LLC

Doing business as ProvideRx of Midland

  • Long Term Care Pharmacy
  • Midland, TX
National Provider Identifier
1093870719
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
26842 Issued in TX
Legal business name
PROVIDERX OF MIDLAND LLC
Doing business as
ProvideRx of Midland
Practice address
2208 N Loop 250 W
Ste 101
Midland, TX 79707-6011
Phone
(432) 689-3355
Fax
(432) 699-6071
NPI assigned
Dec 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Authorized official

Name
Terry Allard
Title
General Manager
Phone
(817) 797-4181

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X 26842 TX Primary

Addresses

Primary practice location

2208 N Loop 250 W
Ste 101
Midland, TX 79707-6011

Mailing address

PO Box 878
Grapevine, TX 76099-0878
Phone (817) 778-8767

Other identifiers 1

IdentifierTypeStateIssuer
4534358OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • ProvideRx of Midland Doing business as

National Provider Directory

National Provider Directory

Locations

2208 N Loop 250 W
Ste 101
Midland, TX 79707
Phone (432) 639-3355

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": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278028800000",
    "number": "1093870719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 878",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760990878",
            "telephone_number": "817-778-8767",
            "fax_number": "866-377-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2208 N LOOP 250 W",
            "address_2": "STE 101",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797076011",
            "telephone_number": "432-689-3355",
            "fax_number": "432-699-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDERX OF MIDLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2010-07-02",
        "status": "A",
        "authorized_official_last_name": "ALLARD",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "817-797-4181"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "TX",
            "license": "26842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4534358",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProvideRx of Midland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; 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.