St Michael's Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

ST MICHAEL'S PHARMACY LLC

Practice address

5102 Avenue H
Rosenberg, TX 77471-2014

Phone

(281) 762-1120

Fax

(281) 762-0544

NPI assigned

Apr 4, 2021

Last updated

Jun 10, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Vincent OmolemeNPI 1619550753

Title

Pharmacist-in-Charge/Owner

Phone

(281) 236-9776

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vincent Ehighe Omoleme

  • Pharmacist
  • Richmond, TX
  • NPI 1619550753
  Authorized official Same address or phone

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

{
    "created_epoch": "1617494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654819200000",
    "number": "1174102586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5102 AVENUE H",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774712014",
            "telephone_number": "281-762-1120",
            "fax_number": "281-762-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5102 AVENUE H",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774712014",
            "telephone_number": "281-762-1120",
            "fax_number": "281-762-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MICHAEL'S PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-04",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A",
        "authorized_official_last_name": "OMOLEME",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARGE/OWNER",
        "authorized_official_telephone_number": "281-236-9776",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Rosenberg, TX
• Providers in Rosenberg, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.