John Ben Knudson

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

03158 Issued in TX

Legal business name

JOHN BEN KNUDSON

Practice address

1001 N Austin St
Comanche, TX 76442-1701

Phone

(325) 356-2585

Fax

(325) 356-2585

NPI assigned

Sep 12, 2006

Organization subpart

No

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

Authorized official

Name

John Knudson, RPH

Title

Owner

Phone

(325) 356-2585

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• COMANCHE PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320624000000",
    "number": "1285738245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N AUSTIN ST",
            "city": "COMANCHE",
            "state": "TX",
            "postal_code": "764421701",
            "telephone_number": "325-356-2585",
            "fax_number": "325-356-2585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N AUSTIN ST",
            "city": "COMANCHE",
            "state": "TX",
            "postal_code": "764421701",
            "telephone_number": "325-356-2585",
            "fax_number": "325-356-2585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN BEN KNUDSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2011-11-07",
        "status": "A",
        "authorized_official_last_name": "KNUDSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "325-356-2585",
        "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": "03158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140091",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4516134",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMANCHE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2011; 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.