NPIMap

Organization Active NPI

Shannon Medical Center

  • Pharmacy
  • San Angelo, TX
National Provider Identifier
1285845214
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
SHANNON MEDICAL CENTER
Practice address
120 E Harris Ave Ste 410
San Angelo, TX 76903-5904
Phone
(325) 747-5389
Fax
(325) 481-8708
NPI assigned
May 24, 2007
Last updated
Mar 20, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SHANNON MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Authorized official

Name
Carlos Robledo, PHARMDNPI 1972925295
Title
Director-Outpatient Pharmacy Servic
Phone
(325) 374-4446

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary

Addresses

Primary practice location

120 E Harris Ave Ste 410
San Angelo, TX 76903-5904

Mailing address

2030 Pulliam St Ste 16
San Angelo, TX 76905-5170
Phone (325) 481-6403

Other names 1

  • SHANNON MEDICAL CENTER Other name

National Provider Directory

National Provider Directory
Tax ID family
Shannon Air Med 19 organizations share this tax ID, including this one
Part of
Shannon Air Med 1

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

120 E Harris Ave
Ste 410
San Angelo, TX 76903
Phone (325) 747-5389

2030 Pulliam St
Ste 16
San Angelo, TX 76905
Phone (325) 747-4246

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1285845214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 PULLIAM ST STE 16",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769055170",
            "telephone_number": "325-481-6403",
            "fax_number": "325-481-8708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E HARRIS AVE STE 410",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035904",
            "telephone_number": "325-747-5389",
            "fax_number": "325-481-8708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHANNON MEDICAL CENTER",
        "enumeration_date": "2007-05-24",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "ROBLEDO",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "DIRECTOR-OUTPATIENT PHARMACY SERVIC",
        "authorized_official_telephone_number": "325-374-4446",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHANNON MEDICAL CENTER",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SHANNON MEDICAL CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.