Organization Active NPI

CBK Pharmacy LLC

  • Long Term Care Pharmacy
  • San Antonio, TX
National Provider Identifier
1104634419
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
CBK PHARMACY LLC
Practice address
1303 McCullough Ave Ste 128
San Antonio, TX 78212-5603
Phone
(210) 227-7207
NPI assigned
Dec 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Authorized official

Name
Mr. Jody R WelchansNPI 1376811562
Title
General Manager
Phone
(210) 227-7207

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

1303 McCullough Ave Ste 128
San Antonio, TX 78212-5603

Mailing address

1303 McCullough Ave Ste 128
San Antonio, TX 78212-5603

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2264342CBK Pharmacy LLC1303 McCullough Ave, Suite 128, San Antonio, TX 78212Certificate of waiverJul 12, 2026

National Provider Directory

National Provider Directory
Tax ID family
CBK Pharmacy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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": "1734566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734566400000",
    "number": "1104634419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 MCCULLOUGH AVE STE 128",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 MCCULLOUGH AVE STE 128",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125603",
            "telephone_number": "210-227-7207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CBK PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-19",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A",
        "authorized_official_last_name": "WELCHANS",
        "authorized_official_first_name": "JODY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "210-227-7207",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.