Bruce'S Market Basket, LTD.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

20885 Issued in TX

Legal business name

BRUCE'S MARKET BASKET, LTD.

Practice address

6001 39TH St
Groves, TX 77619-4651

Phone

(409) 749-6405

Fax

(409) 749-6505

NPI assigned

May 17, 2006

Organization subpart

No

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

Authorized official

Name

David Skylar Thompson

Title

President

Phone

(409) 727-3104

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bruce's Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 2

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

• Lana Locascio Candiloro, RPH

  • Pharmacist
  • Groves, TX
  • NPI 1447802335
  NPD (past)
• Horace Lynn Miller, RPH

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Groves, TX
  • NPI 1144880865
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296777600000",
    "number": "1265484356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1717",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776271717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 39TH ST",
            "city": "GROVES",
            "state": "TX",
            "postal_code": "776194651",
            "telephone_number": "409-749-6405",
            "fax_number": "409-749-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE'S MARKET BASKET, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2011-02-04",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "SKYLAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "409-727-3104"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "20885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143495",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bruce's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Suzanna Ahmed
• Nneamaka Ajaero, PHARM.D
• Allied Physicians Group PLLC
• Amber Malescha Banken, L.P.C.
• Big Hill Bayou Emergency Physicians
• Lana Locascio Candiloro, RPH
• Angela Carpenter, LMT
• Cindy Lee Carranza, RPH
• Thmerica Michelle Castellaw
• Elizabeth Chavez Valencia

• All providers in Groves, TX
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2011; 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.