Active NPI
Healthville Pharmacy LLC
- Home Infusion Therapy Pharmacy
- Laredo, TX
National Provider Identifier
1194276204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Infusion Therapy Pharmacy
- Legal business name
- HEALTHVILLE PHARMACY LLC
- Doing business as
- HEALTHVILLE PHARMACY
- Practice address
- 7215 McPherson Rd
Laredo, TX 78041 - Phone
- (956) 701-3349
- Fax
- (956) 701-3497
- NPI assigned
- Oct 24, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kehinde Kelvin Busari
- Title
- Pharmacy Manager
- Phone
- (956) 701-3349
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 31006 | TX | |
| Home Infusion Agency | 251F00000X | |||
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Customized Equipment (DME) | 332BC3200X | |||
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | |||
| Compounding Pharmacy | 3336C0004X | |||
| Home Infusion Therapy Pharmacy | 3336H0001X | Primary |
Addresses
Primary practice location
7215 McPherson Rd
Laredo, TX 78041
Mailing address
7215 McPherson Rd
Laredo, TX 78041-6554
Phone (956) 701-3349
Other practice location 1
7215 McPherson Rd
Laredo, TX 78041
Phone (956) 701-3349
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 149537 | Medicaid | TX |
Other names 1
- HEALTHVILLE PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161117002126 | TX | Part B Supplier - Pharmacy | 6608155445 | Practice locations: Laredo, TX |
National Provider Directory
National Provider DirectoryLocations
1029 Bob Bullock Loop
Ste 2
Laredo, TX 78043
Phone (956) 701-3349
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Student in an Organized Health Care Education/Training Program
- Manchester, NH
- NPI 1992095442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477267200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1697760000000",
"number": "1194276204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7215 MCPHERSON RD",
"city": "LAREDO",
"state": "TX",
"postal_code": "780416554",
"telephone_number": "956-701-3349",
"fax_number": "956-701-3497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7215 MCPHERSON RD",
"city": "LAREDO",
"state": "TX",
"postal_code": "78041",
"telephone_number": "956-701-3349",
"fax_number": "956-701-3497"
}
],
"practiceLocations": [
{
"address_1": "7215 McPherson Rd",
"address_purpose": "LOCATION",
"city": "Laredo",
"state": "TX",
"postal_code": "78041",
"country_code": "US",
"telephone_number": "956-701-3349",
"fax_number": "956-701-3497",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "HEALTHVILLE PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-10-24",
"last_updated": "2023-10-20",
"certification_date": "2023-10-20",
"status": "A",
"authorized_official_last_name": "BUSARI",
"authorized_official_first_name": "KEHINDE",
"authorized_official_middle_name": "KELVIN",
"authorized_official_title_or_position": "PHARMACY MANAGER",
"authorized_official_telephone_number": "956-701-3349",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "TX",
"license": "31006",
"primary": false
},
{
"code": "251F00000X",
"taxonomy_group": "",
"desc": "Home Infusion",
"state": null,
"license": null,
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": null,
"license": null,
"primary": false
},
{
"code": "332BP3500X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336H0001X",
"taxonomy_group": "",
"desc": "Pharmacy, Home Infusion Therapy Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "149537",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "HEALTHVILLE PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Laredo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.