NPIMap

Organization Active NPI

Tricare Pharmacy LLC

  • Community/Retail Pharmacy
  • Houston, TX
National Provider Identifier
1134490840
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
27973 Issued in TX
Legal business name
TRICARE PHARMACY LLC
Practice address
5225 Katy Fwy Ste 101a
Houston, TX 77007-2292
Phone
(281) 953-0030
Fax
(281) 953-0028
NPI assigned
Jan 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Authorized official

Name
Gloria Mbonu
Title
Founder/Ceo
Phone
(281) 953-0030

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 27973 TX Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

5225 Katy Fwy Ste 101a
Houston, TX 77007-2292

Mailing address

PO Box 113
Alief, TX 77411-0113
Phone (281) 953-0030

Other identifiers 1

IdentifierTypeStateIssuer
2134592OtherPK

Other names 1

  • Tonna Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tonna Pharmacy2 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.

NPI Registry JSON

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

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473292800000",
    "number": "1134490840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 113",
            "city": "ALIEF",
            "state": "TX",
            "postal_code": "774110113",
            "telephone_number": "281-953-0030",
            "fax_number": "281-953-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 KATY FWY STE 101A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770072292",
            "telephone_number": "281-953-0030",
            "fax_number": "281-953-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRICARE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-26",
        "last_updated": "2016-09-08",
        "status": "A",
        "authorized_official_last_name": "MBONU",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "FOUNDER/CEO",
        "authorized_official_telephone_number": "281-953-0030"
    },
    "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": "27973",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2134592",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tonna Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.