The Medicine Shoppe

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

THE MEDICINE SHOPPE

Practice address

1417 E Airline Rd
Victoria, TX 77901-4111

Phone

(361) 573-6385

Fax

(361) 573-1617

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Dena Ferman

Title

Third Party Plan Coordinator

Phone

(314) 993-6000

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1316019110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 E AIRLINE RD",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779014111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 E AIRLINE RD",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779014111",
            "telephone_number": "361-573-6385",
            "fax_number": "361-573-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MEDICINE SHOPPE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "FERMAN",
        "authorized_official_first_name": "DENA",
        "authorized_official_title_or_position": "THIRD PARTY PLAN COORDINATOR",
        "authorized_official_telephone_number": "314-993-6000"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "17002",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144412",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4533128",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Texas Independence Health Plan Inc.
• Texas Internal Medicine & Diagnostic Center
• Texas Medical&Wellness Clinic P.a.
• Malarvizhi Thangavelu, MD
• David Bruce Tharp, MD
• The Young Men's Christian Association of Golden Crescent, Inc.
• Theracare P.C.
• Kevin Thi
• Third Coast Anesthesia Associates, PLLC
• Chris Thomas, DC

• Community/Retail Pharmacy in Victoria, TX
• Providers in Victoria, TX by specialty
• Community/Retail Pharmacy in Texas

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