NPIMap

Organization Active NPI

Savon Pharmacy #4155

  • Pharmacist
  • Odessa, TX
National Provider Identifier
1285794842
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
14866 Issued in TX
Legal business name
SAVON PHARMACY #4155
Practice address
4950 E 42ND St
Odessa, TX 79762-7240
Phone
(432) 367-4612
Fax
(432) 367-1630
NPI assigned
Dec 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Linda C Mick, PHARMD
Title
Pharmacist-in-Charge
Phone
(432) 367-4612

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 14866 TX Primary

Addresses

Primary practice location

4950 E 42ND St
Odessa, TX 79762-7240

Mailing address

4950 E 42ND St
Odessa, TX 79762-7240
Phone (432) 367-4612

Other identifiers 1

IdentifierTypeStateIssuer
463402MedicaidTX

Other names 1

  • Albertson's LLC Other name

National Provider Directory

National Provider Directory
Tax ID family
Albertsons Inc 4103388 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285794842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 E 42ND ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797627240",
            "telephone_number": "432-367-4612",
            "fax_number": "432-367-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 E 42ND ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797627240",
            "telephone_number": "432-367-4612",
            "fax_number": "432-367-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAVON PHARMACY #4155",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MICK",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARGE",
        "authorized_official_telephone_number": "432-367-4612",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "14866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "463402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Albertson's LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.