Wylie Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28505 Issued in TX

Legal business name

WYLIE PHARMACY LLC

Doing business as

Wylie Pharmacy

Practice address

430 S Highway 78 Ste 160
Wylie, TX 75098-3974

Phone

(972) 429-9594

Fax

(972) 429-9482

NPI assigned

Jul 11, 2013

Last updated

Jan 14, 2014By 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

Srikrishna Boppana

Title

Pic

Phone

(972) 429-9594

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Wylie Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389657600000",
    "number": "1225479819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 S HIGHWAY 78",
            "address_2": "SUITE 160",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750983905",
            "telephone_number": "972-429-9594",
            "fax_number": "972-429-9482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 S HIGHWAY 78 STE 160",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750983974",
            "telephone_number": "972-429-9594",
            "fax_number": "972-429-9482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYLIE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-11",
        "last_updated": "2014-01-14",
        "status": "A",
        "authorized_official_last_name": "BOPPANA",
        "authorized_official_first_name": "SRIKRISHNA",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "972-429-9594"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "28505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2141040",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146807",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wylie Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wylie Ep PLLC
• Wylie ER, LLC (Wylie ER)
• Wylie Fire-Rescue
• Wylie Independent School District
• Wylie Medical Center (First Choice Emergency Room)
• Wylie Senior Care (Wylie Nursing & Rehab)
• Wylie Smiles PLLC
• Jill Yarbrough, LCSW
• Chantelle Young, LVN/LPN
• Brian Alan Yount, OTR

• Community/Retail Pharmacy in Wylie, TX
• Providers in Wylie, 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 Jan 14, 2014; 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.