Goose Creek Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

30867 Issued in TX

Legal business name

GOOSE CREEK PHARMACY LLC

Doing business as

Goose Creek Pharmacy

Practice address

2007 N Main St
Baytown, TX 77520-2746

Phone

(281) 838-8640

Fax

(281) 628-7970

NPI assigned

Aug 12, 2016

Last updated

Jul 19, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey Terry

Title

Pic/Sole Owner/Ao

Phone

(281) 838-8640

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Goose Creek Pharmacy Doing business as

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

{
    "created_epoch": "1470960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1104370659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 N MAIN ST",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775202746",
            "telephone_number": "281-838-8640",
            "fax_number": "281-628-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 N MAIN ST",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775202746",
            "telephone_number": "281-838-8640",
            "fax_number": "281-628-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOSE CREEK PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-12",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PIC/SOLE OWNER/AO",
        "authorized_official_telephone_number": "281-838-8640"
    },
    "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": "30867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2162475",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149527",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goose Creek Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dominique Goode
• Christi Gaines Goodman, OTR
• Goose Creek Consolidated Independent School District
• Goose Creek Emergency Physicians PLLC
• Goose Creek Isd
• Mary S Goswitz, MD
• Hillary R Gotham, M.S.
• Jennifer L Gould, R.D., L.D.
• GR Cure
• Grace in Place Hospice LLC

• Community/Retail Pharmacy in Baytown, TX
• Providers in Baytown, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.