Dogwood Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

30042 Issued in TX

Legal business name

DOGWOOD PHARMACY LLC

Practice address

205 S Magnolia St
Woodville, TX 75979-5234

Phone

(409) 283-7509

Fax

(409) 283-7395

NPI assigned

Aug 18, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey Scott Terry, RPH

Title

Sole Owner

Phone

(409) 283-7509

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 2

• Dogwood PHarmacy and Gift Doing business as
• Dogwood Pharmacy and Gifts Doing business as

Locations

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1164536157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S MAGNOLIA ST",
            "city": "WOODVILLE",
            "state": "TX",
            "postal_code": "759795234",
            "telephone_number": "409-283-7509",
            "fax_number": "409-283-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S MAGNOLIA ST",
            "city": "WOODVILLE",
            "state": "TX",
            "postal_code": "759795234",
            "telephone_number": "409-283-7509",
            "fax_number": "409-283-7395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOGWOOD PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "409-283-7509",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "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": "30042",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2153503",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147143",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dogwood PHarmacy and Gift",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dogwood Pharmacy and Gifts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Selia Davis, CPNP
• Paula Lajean Denson, M.D.
• Ellis Rodney Derouen, R.PH
• Lisa Ann Dickey, C.O.T.A.
• Dmctx1, PLLC
• Dogwood Pharmacy LLC
• Doucette Branch Inpatient Services PLLC
• Bukola Durojaiye
• East Texas Family Healthcare PLLC
• Nicole M Ellison, M.D.

• All providers in Woodville, TX
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; 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.