3 Wild Ones LLC
Organization Active NPI Community/Retail Pharmacy · San Antonio, TX
NPI 1134540917 · NPPES record last updated Mar 19, 2025
Key facts
- NPI
- 1134540917
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- 3 WILD ONES LLC
- Practice address
- 26108 Overlook Pkwy
BLDG 4
San Antonio, TX 78260 - Phone
- (210) 819-4515
- Fax
- (210) 819-4516
- NPI assigned
- Dec 23, 2013
- Organization subpart
- No
Authorized official
- Name
- Christopher Michael Louis Berard, PHARM D
- Title
- Owner
- Phone
- (504) 481-5364
Practitioners 2
-
Christopher Michael Louis Berard, PHARMD
-
Jessica Virleen Simpson, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250612002630 | TX | Part B Supplier - Pharmacy | 5294246708 | Practice locations: San Antonio, TX |
National Provider Directory
Locations
26108 Overlook Pkwy
Bldg 4
San Antonio, TX 78260
Phone (210) 819-4515
26108 Overlook Pkwy
San Antonio, TX 78260
Phone (210) 819-4515
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
26108 Overlook Pkwy
BLDG 4
San Antonio, TX 78260
Mailing address
33 Sulfur Cyn
San Antonio, TX 78247
Phone (504) 481-5364
Other names
- Good Life Pharmacy
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.