NPIMap

Organization Active NPI

LSCC Georgetown Pharmacy- Williams Drive

  • Community/Retail Pharmacy
  • Georgetown, TX
National Provider Identifier
1093956062
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
26364 Issued in TX
Legal business name
LSCC GEORGETOWN PHARMACY- WILLIAMS DRIVE
Doing business as
LSCC Georgetown Pharmacy- Williams Drive
Practice address
2423 Williams Dr
Suite 109
Georgetown, TX 78628-3200
Phone
(512) 686-0155
Fax
(512) 869-8482
NPI assigned
Mar 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Authorized official

Name
Jonathan David Calvin
Title
Ceo
Phone
(877) 800-5722

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 26364 TX Primary

Addresses

Primary practice location

2423 Williams Dr
Suite 109
Georgetown, TX 78628-3200

Mailing address

2423 Williams Dr Ste 107
Georgetown, TX 78628-3269
Phone (877) 800-5722

Other identifiers 1

IdentifierTypeStateIssuer
2119479OtherPK

Other names 1

  • LSCC Georgetown Pharmacy- Williams Drive Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lone Star Circle of Care34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

View all 33

Locations

2423 Williams Dr
Ste 109
Georgetown, TX 78628
Phone (512) 686-0155

NPI Registry JSON

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

{
    "created_epoch": "1237507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745971200000",
    "number": "1093956062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 WILLIAMS DR STE 107",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283269",
            "telephone_number": "877-800-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 WILLIAMS DR",
            "address_2": "SUITE 109",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283200",
            "telephone_number": "512-686-0155",
            "fax_number": "512-869-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LSCC GEORGETOWN PHARMACY- WILLIAMS DRIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-20",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A",
        "authorized_official_last_name": "CALVIN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "877-800-5722"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "26364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2119479",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LSCC Georgetown Pharmacy- Williams Drive",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; 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.