Active NPI
Kevin Concannon LLC
Doing business as Lifeline Pharmacy 1
- Community/Retail Pharmacy
- Edinburg, TX
National Provider Identifier
1275240780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- KEVIN CONCANNON LLC
- Doing business as
- Lifeline Pharmacy 1
- Practice address
- 2500 W Trenton Rd Ste 12
Edinburg, TX 78539-8023 - Phone
- (520) 730-7575
- NPI assigned
- Nov 3, 2022
- Organization subpart
- Yes
- Parent organization
- KEVIN CONCANNON LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kevin Concannon
- Title
- Ceo
- Phone
- (520) 730-7575
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
2500 W Trenton Rd Ste 12
Edinburg, TX 78539-8023
Mailing address
4840 E Salida del Sol PL
Tucson, AZ 85718-5410
Phone (520) 730-7575
Other names 1
- Lifeline Pharmacy 1
National Provider Directory
National Provider Directory- Tax ID family
- Kevin Concannon LLC
- Part of
- Kevin Concannon LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Locations
2500 W Trenton Rd
Ste 12
Edinburg, TX 78539
Phone (956) 255-5155
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667433600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1667433600000",
"number": "1275240780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4840 E SALIDA DEL SOL PL",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857185410",
"telephone_number": "520-730-7575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 W TRENTON RD STE 12",
"city": "EDINBURG",
"state": "TX",
"postal_code": "785398023",
"telephone_number": "520-730-7575"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KEVIN CONCANNON LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "KEVIN CONCANNON LLC",
"enumeration_date": "2022-11-03",
"last_updated": "2022-11-03",
"certification_date": "2022-11-03",
"status": "A",
"authorized_official_last_name": "CONCANNON",
"authorized_official_first_name": "KEVIN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "520-730-7575"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Lifeline Pharmacy 1",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Edinburg, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.