Active NPI
East Austin Medicine Shop
- Community/Retail Pharmacy
- Austin, TX
National Provider Identifier
1154790376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 30135
- Legal business name
- EAST AUSTIN MEDICINE SHOP
- Practice address
- 1909 E 38TH 1/2 St Ste C2
Austin, TX 78723-5749 - Phone
- (512) 643-0999
- Fax
- (512) 643-4074
- NPI assigned
- Sep 17, 2015
- 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
- Christopher John Perling, RPH
- Title
- Pic
- Phone
- (512) 643-0999
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 30135 | TX | Primary |
Addresses
Primary practice location
1909 E 38TH 1/2 St Ste C2
Austin, TX 78723-5749
Mailing address
1909 E 38TH 1/2 St Ste C2
Austin, TX 78723-5749
Phone (512) 643-0999
Other names 1
- East Austin Medicine Shop
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211027001139 | TX | Part B Supplier - Pharmacy | 7618365461 | Practice locations: Austin, TX |
National Provider Directory
National Provider DirectoryLocations
2115 E Mlk Blvd
Austin, TX 78702
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Austin, TX
- NPI 1326487398
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442448000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1635120000000",
"number": "1154790376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1909 E 38TH 1/2 ST STE C2",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787235749",
"telephone_number": "512-643-0999",
"fax_number": "512-643-4074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1909 E 38TH 1/2 ST STE C2",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787235749",
"telephone_number": "512-643-0999",
"fax_number": "512-643-4074"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EAST AUSTIN MEDICINE SHOP",
"organizational_subpart": "NO",
"enumeration_date": "2015-09-17",
"last_updated": "2021-10-25",
"certification_date": "2021-10-25",
"status": "A",
"authorized_official_last_name": "PERLING",
"authorized_official_first_name": "CHRISTOPHER",
"authorized_official_middle_name": "JOHN",
"authorized_official_title_or_position": "PIC",
"authorized_official_telephone_number": "512-643-0999",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "TX",
"license": "30135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "East Austin Medicine Shop",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.