Active NPI
Medical Plaza Pharmacy
- Pharmacist
- Longview, TX
National Provider Identifier
1114342706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 23337
- Legal business name
- MEDICAL PLAZA PHARMACY
- Practice address
- 707 E Marshall Ave Ste 7
Longview, TX 75601-5575 - Phone
- (903) 757-3477
- Fax
- (903) 757-3134
- NPI assigned
- Feb 19, 2014
- Last updated
- Feb 19, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Don Novak, RPH
- Title
- RPH Owner
- Phone
- 90375734377
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 23337 | TX | Primary |
Addresses
Primary practice location
707 E Marshall Ave Ste 7
Longview, TX 75601-5575
Mailing address
707 E Marshall Ave Ste 7
Longview, TX 75601-5575
Phone (903) 757-3477
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 140560 | Medicaid | TX |
Other names 1
- the pharmacy of longview
National Provider Directory
National Provider Directory- Tax ID family
- Medical Plaza Pharmacy
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Longview, TX
- NPI 1265860621
-
dba Medical Plaza Pharmacy
- Community/Retail Pharmacy
- Longview, TX
- NPI 1598709800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392768000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1392768000000",
"number": "1114342706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 E MARSHALL AVE STE 7",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756015575",
"telephone_number": "903-757-3477",
"fax_number": "903-757-3134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 E MARSHALL AVE STE 7",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756015575",
"telephone_number": "903-757-3477",
"fax_number": "903-757-3134"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDICAL PLAZA PHARMACY",
"organizational_subpart": "NO",
"enumeration_date": "2014-02-19",
"last_updated": "2014-02-19",
"status": "A",
"authorized_official_last_name": "NOVAK",
"authorized_official_first_name": "DON",
"authorized_official_title_or_position": "RPH OWNER",
"authorized_official_telephone_number": "90375734377",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "23337",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140560",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "the pharmacy of longview",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Longview, TX
- Med Shop Total Care Inc (Med Shop Total Care Pharmacy)
- Med Shop Total Care, Inc (Med Shop Medical Depot)
- Med Southwest, PLLC (MyEyeDr.)
- Med Southwest, PLLC (MyEyeDr.)
- Medical Imaging Consultants LLP
- Medical Plaza Pharmacy
- Medical Records Analysis L.L.C.
- Medstop Clinic
- Craig A Meek, MD
- Suzanne M Meek, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.