Lynn'S la Vega Pharmacy, Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

LYNN'S LA VEGA PHARMACY, INC

Practice address

2401 E Waco Dr
Waco, TX 76705-3259

Phone

(254) 799-4949

NPI assigned

Jul 13, 2018

Organization subpart

No

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

Authorized official

Name

Brady Lynn EverettNPI 1770194508

Title

President

Phone

(254) 799-4949

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brady Everett

  • Pharmacist
  • Waco, TX
  • NPI 1770194508
  NPD Authorized official
• Michelle Renae Johnson, RPH

  • Pharmacist
  • Waco, TX
  • NPI 1457846883
  NPD (past)
• John Stephen Menard, R.PH.

  • Pharmacist
  • Waco, TX
  • NPI 1972614360
  NPD (past)
• Hannah Faith Ramirez, PHARM.D.

  • Pharmacist
  • Waco, TX
  • NPI 1952826117
  NPD (past)
• David Benjamin Smith, PHARMD

  • Pharmacist
  • Waco, TX
  • NPI 1356835516
  NPD (past)

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

{
    "created_epoch": "1531440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538956800000",
    "number": "1194201178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 E WACO DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767053259",
            "telephone_number": "254-799-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 E WACO DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767053259",
            "telephone_number": "254-799-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNN'S LA VEGA PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-13",
        "last_updated": "2018-10-08",
        "status": "A",
        "authorized_official_last_name": "EVERETT",
        "authorized_official_first_name": "BRADY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "254-799-4949"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141863",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2096115",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Kay Lyles, LAT, ATC
• Ronda C Lyles
• Kira Lynch, DDS
• Melissa K Lynn, WHNP-BC
• Sandra D. Lynn, CRNA
• Lynns la Vega Pharmacy Inc
• Justin Lyons, PTA
• M-R Medical Inc
• M&T Pharmacy Solutions, LLC
• Mabell'S Place

• Long Term Care Pharmacy in Waco, TX
• Providers in Waco, TX by specialty
• Long Term Care Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; 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.