NPIMap

Organization Active NPI

Minyard Food Stores Inc.

  • Community/Retail Pharmacy
  • Ft Worth, TX
National Provider Identifier
1104904150
Registry record updated Nov 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
18688 Issued in TX
Legal business name
MINYARD FOOD STORES INC.
Practice address
102 NW 28TH St
Ft Worth, TX 76106-7115
Phone
(817) 625-2462
Fax
(817) 624-4896
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2007

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

Authorized official

Name
Mr. Michael D. Byars
Title
President/Ceo
Phone
(972) 393-8700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 18688 TX Primary

Addresses

Primary practice location

102 NW 28TH St
Ft Worth, TX 76106-7115

Mailing address

102 NW 28TH St
Ft Worth, TX 76106-7115
Phone (817) 625-2462

Other identifiers 2

IdentifierTypeStateIssuer
4501171OtherTXNCPDP
464222MedicaidTX

Other names 1

  • Carnival Pharmacy #120 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Minyard Food Stores Inc32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

Locations

102 NW 28th St
Ft Worth, TX 76164
Phone (817) 625-2462

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195171200000",
    "number": "1104904150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 NW 28TH ST",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761067115",
            "telephone_number": "817-625-2462",
            "fax_number": "817-624-4896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 NW 28TH ST",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761067115",
            "telephone_number": "817-625-2462",
            "fax_number": "817-624-4896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINYARD FOOD STORES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-11-16",
        "status": "A",
        "authorized_official_last_name": "BYARS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "972-393-8700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "18688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4501171",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "464222",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carnival Pharmacy #120",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ft Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.