Medicine Place Inc 1008 Lamar St Sweetwater TX

Primary specialty

PharmacyTaxonomy code 333600000X

License

10882 Issued in TX

Legal business name

MEDICINE PLACE INC 1008 LAMAR ST SWEETWATER TX

Practice address

2250 Chestnut St.
Colorado City, TX 79512-3485

Phone

(325) 728-3489

Fax

(325) 728-8683

NPI assigned

Aug 18, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Paul Gilbert Johnson, R.PH.NPI 1740873546

Title

Pharmacist in Charge/V.P./Owner

Phone

(325) 728-3489

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• The Medicine Place Pharmacy #2 Other name

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Medicine Place Inc 1008 Lamar St Sweetwater TX

  • Oxygen Equipment & Supplies (DME)
  • Sweetwater, TX
  • NPI 1194906446

  0446312466

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Medicine Place Inc 1008 Lamar St Sweetwater TX

  • Oxygen Equipment & Supplies (DME)
  • Sweetwater, TX
  • NPI 1194906446

  O20111123000284

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

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

• Paul Gilbert Johnson, R.PH.

  • Pharmacist
  • Colorado City, TX
  • NPI 1740873546
  NPD (past) Authorized official

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1265424832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 CHESTNUT ST.",
            "city": "COLORADO CITY",
            "state": "TX",
            "postal_code": "795123485",
            "telephone_number": "325-728-3489",
            "fax_number": "325-728-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 CHESTNUT ST.",
            "city": "COLORADO CITY",
            "state": "TX",
            "postal_code": "795123485",
            "telephone_number": "325-728-3489",
            "fax_number": "325-728-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINE PLACE INC 1008 LAMAR ST SWEETWATER TX",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-18",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "GILBERT",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE/V.P./OWNER",
        "authorized_official_telephone_number": "325-728-3489",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "10882",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "10882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142688",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP# (FORMERLY NABP#)",
            "identifier": "4567814",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX STATE BOARD LIC #",
            "identifier": "10882",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medicine Place Pharmacy #2",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kaitlyn Alexis Kimball
• Kristi Lee Manor Inc
• Virginia S Maggard
• Kaylee Martin
• Michael Steven McAndrew, O.D.
• Michael S. White
• Mitchell County Ambulance Service
• Mitchell County Hospital
• Mitchell County Hospital District
• Mitchell County Hospital District

• Pharmacy in Colorado City, TX
• Providers in Colorado City, TX by specialty
• Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.