TDCS, LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

269 Issued in NE

Legal business name

TDCS, LLC

Practice address

13831 Chalco Valley Pkwy
Suite 101
Omaha, NE 68138-6145

Phone

(402) 763-6520

Fax

(402) 763-6521

NPI assigned

Dec 29, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Timothy S Decker

Title

President

Phone

(402) 592-5244

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MEDWELLRX Doing business as

Locations

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1104982404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13831 CHALCO VALLEY PKWY",
            "address_2": "SUITE 101",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681386145",
            "telephone_number": "402-763-6520",
            "fax_number": "402-763-6521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13831 CHALCO VALLEY PKWY",
            "address_2": "SUITE 101",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681386145",
            "telephone_number": "402-763-6520",
            "fax_number": "402-763-6521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TDCS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "DECKER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-592-5244",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NE",
            "license": "269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100254471-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDWELLRX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in Omaha, NE
• Providers in Omaha, NE by specialty
• Long Term Care Pharmacy in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.