PBG Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

24956 Issued in TX

Legal business name

PBG INC

Doing business as

Buda Drug Store

Practice address

203 Railroad St
Build 2 Ste B
Buda, TX 78610-3383

Phone

(512) 312-2111

Fax

(512) 295-8300

NPI assigned

Jun 19, 2006

Last updated

Mar 22, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tammy Gray, RPH

Title

Owner

Phone

(512) 913-3480

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• BUDA DRUG STORE Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Tax ID family

Buda Drug Store2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• PBG Inc

  • Long Term Care Pharmacy
  • Buda, TX
  • NPI 1013740026
  NPD tax ID

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647907200000",
    "number": "1215972435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 RAILROAD ST",
            "address_2": "BUILD 2 STE B",
            "city": "BUDA",
            "state": "TX",
            "postal_code": "786103383",
            "telephone_number": "512-312-2111",
            "fax_number": "512-295-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 RAILROAD ST",
            "address_2": "BUILD 2 STE B",
            "city": "BUDA",
            "state": "TX",
            "postal_code": "786103383",
            "telephone_number": "512-312-2111",
            "fax_number": "512-295-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PBG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-913-3480",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "24956",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4540666",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145666",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BUDA DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BUDA DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carley Chenee Palomo, PHARMACY TECHNICIAN
• Lilly Dennise Parker, RDN, LD
• Kaitlin Pate
• Emily Jane Patterson, M.ED.
• PBG Inc
• Skyler Pearlman
• Venessa Pena-Robichaux, M.D.
• Pentacle Exams
• Tiffanee Perry
• Tori Pesek

• Community/Retail Pharmacy in Buda, TX
• Providers in Buda, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; 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.

Verify at the official NPI Registry.