Belle Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

29002 Issued in TX

Legal business name

BELLE PHARMACY, LLC

Practice address

1100 Jackson Street, Suite D
Richmond, TX 77469

Phone

(346) 230-4125

Fax

(832) 202-2556

NPI assigned

Sep 7, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Kyla Celeste Mittanck, RPH

Title

Pic/Authorized Signatory

Phone

(346) 230-4125

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Patients Assistance, LLC Former legal business name

Locations

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516752000000",
    "number": "1245333699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 JACKSON STREET, SUITE D",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "77469",
            "telephone_number": "346-230-4125",
            "fax_number": "832-202-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JACKSON STREET, SUITE D",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "77469",
            "telephone_number": "346-230-4125",
            "fax_number": "832-202-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLE PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2018-01-24",
        "status": "A",
        "authorized_official_last_name": "MITTANCK",
        "authorized_official_first_name": "KYLA",
        "authorized_official_middle_name": "CELESTE",
        "authorized_official_title_or_position": "PIC/AUTHORIZED SIGNATORY",
        "authorized_official_telephone_number": "346-230-4125",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "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": "29002",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470982",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2144608",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patients Assistance, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Community/Retail Pharmacy in Richmond, TX
• Providers in Richmond, 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 24, 2018; 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.