NPIMap

Organization Active NPI

Pancho Independent Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Grand Prairie, TX
National Provider Identifier
1215266549
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
23336 Issued in TX
Legal business name
PANCHO INDEPENDENT PHARMACY, INC.
Practice address
2985 S Hwy 360
Suite 145
Grand Prairie, TX 75052-6414
Phone
(972) 660-8884
Fax
(972) 660-8886
NPI assigned
Dec 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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

Authorized official

Name
Dr. Francis E. Njie
Title
Pharmacist
Phone
(972) 660-8884

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 23336 TX Primary

Addresses

Primary practice location

2985 S Hwy 360
Suite 145
Grand Prairie, TX 75052-6414

Mailing address

2985 S Hwy 360
Suite 145
Grand Prairie, TX 75052-6414
Phone (972) 660-8884

Other identifiers 1

IdentifierTypeStateIssuer
145862MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Doctor'S Plaza Pharmacy5 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.

NPI Registry JSON

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

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260921600000",
    "number": "1215266549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2985 S HWY 360",
            "address_2": "SUITE 145",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750526414",
            "telephone_number": "972-660-8884",
            "fax_number": "972-660-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2985 S HWY 360",
            "address_2": "SUITE 145",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750526414",
            "telephone_number": "972-660-8884",
            "fax_number": "972-660-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANCHO INDEPENDENT PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-16",
        "last_updated": "2009-12-16",
        "status": "A",
        "authorized_official_last_name": "NJIE",
        "authorized_official_first_name": "FRANCIS",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "972-660-8884",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "23336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145862",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; 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.