Red Door Pharmacy and Gifts LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

31211 Issued in TX

Legal business name

RED DOOR PHARMACY AND GIFTS LLC

Doing business as

Red Door Pharmacy and Gifts

Practice address

2488 Avondale Haslet Rd Ste 168
Haslet, TX 76052-3220

Phone

(817) 259-2636

Fax

(817) 259-2636

NPI assigned

Jan 26, 2017

Organization subpart

No

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

Authorized official

Name

Randy Shipp, PHARMDNPI 1669056057

Title

Owner, Pharmacist in Charge

Phone

(817) 259-1463

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Red Door Pharmacy and Gifts Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Randy Shipp, PHARMD

  • Pharmacist
  • Haslet, TX
  • NPI 1669056057
  NPD Authorized official

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

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1235676347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2488 AVONDALE HASLET RD STE 168",
            "city": "HASLET",
            "state": "TX",
            "postal_code": "760523441",
            "telephone_number": "903-466-4662",
            "fax_number": "817-259-2636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2488 AVONDALE HASLET RD STE 168",
            "city": "HASLET",
            "state": "TX",
            "postal_code": "760523220",
            "telephone_number": "817-259-2636",
            "fax_number": "817-259-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED DOOR PHARMACY AND GIFTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-26",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "SHIPP",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "OWNER, PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "817-259-1463",
        "authorized_official_credential": "PHARMD"
    },
    "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": "31211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167423",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Door Pharmacy and Gifts",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Red Door Pharmacy and Gifts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Haslet, TX
• Providers in Haslet, 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 Dec 8, 2021; 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.