Organization Active NPI

US Drug Mart Inc

  • Community/Retail Pharmacy
  • Fabens, TX
National Provider Identifier
1194236182
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
31573 Issued in TX
Legal business name
US DRUG MART INC
Practice address
1420 Fabens Rd Ste B
Fabens, TX 79838
Phone
(915) 764-2739
Fax
(915) 764-7639
NPI assigned
Oct 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Authorized official

Name
David Paschal
Title
Vice President
Phone
(972) 775-1180

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 31573 TX Primary

Addresses

Primary practice location

1420 Fabens Rd Ste B
Fabens, TX 79838

Mailing address

PO Box 1233
Fabens, TX 79838-1233
Phone (915) 764-2739

Other identifiers 2

IdentifierTypeStateIssuer
149710MedicaidTX
2172043OtherPK

Other names 1

  • Fabens Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180403001300 TX Part B Supplier - Mass Immunization (Roster Biller Only) 6709858558 Practice locations: Fabens, TX

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2148548Fabens Pharmacy1420 Fabens Road, Suite B, Fabens, TX 79838Certificate of waiverMay 13, 2028

National Provider Directory

National Provider Directory
Tax ID family
US Drug Mart Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680220800000",
    "number": "1194236182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1233",
            "city": "FABENS",
            "state": "TX",
            "postal_code": "798381233",
            "telephone_number": "915-764-2739",
            "fax_number": "915-764-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 FABENS RD STE B",
            "city": "FABENS",
            "state": "TX",
            "postal_code": "79838",
            "telephone_number": "915-764-2739",
            "fax_number": "915-764-7639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "US DRUG MART INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-17",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A",
        "authorized_official_last_name": "PASCHAL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "972-775-1180"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "31573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149710",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2172043",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fabens Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fabens, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.