NPIMap

Organization Active NPI

Brandy Pharmacy Corp

  • Community/Retail Pharmacy
  • Mesquite, TX
National Provider Identifier
1194261024
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
31336 Issued in TX
Legal business name
BRANDY PHARMACY CORP
Practice address
910 N Galloway Ave Ste 303
Mesquite, TX 75149-2409
Phone
(972) 773-9001
Fax
(972) 773-9584
NPI assigned
Jan 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Authorized official

Name
Nedal Naser
Title
Owner, Ao
Phone
(972) 773-9001

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 31336 TX Primary

Addresses

Primary practice location

910 N Galloway Ave Ste 303
Mesquite, TX 75149-2409

Mailing address

PO Box 851766
Mesquite, TX 75185-1766
Phone (972) 773-9001

Other identifiers 1

IdentifierTypeStateIssuer
2167300OtherPK

Other names 1

  • Brandy Pharmacy 2 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Brandy Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

910 N Galloway Ave
Ste 303
Mesquite, TX 75149
Phone (972) 773-9001

NPI Registry JSON

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574812800000",
    "number": "1194261024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 851766",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751851766",
            "telephone_number": "972-773-9001",
            "fax_number": "972-773-9584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 N GALLOWAY AVE STE 303",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751492409",
            "telephone_number": "972-773-9001",
            "fax_number": "972-773-9584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDY PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-17",
        "last_updated": "2019-11-27",
        "status": "A",
        "authorized_official_last_name": "NASER",
        "authorized_official_first_name": "NEDAL",
        "authorized_official_title_or_position": "OWNER,  AO",
        "authorized_official_telephone_number": "972-773-9001"
    },
    "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": "31336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167300",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brandy Pharmacy 2",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brandy Pharmacy 2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.