Lifeline Pharmacy 1 LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

LIFELINE PHARMACY 1 LLC

Practice address

2500 W Trenton Road
Suite 12
Edinburg, TX 78539

Phone

(956) 255-5515

NPI assigned

Mar 19, 2020

Organization subpart

No

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

Authorized official

Name

Mobeen Ahmed

Title

Managing Member

Phone

(845) 283-7474

Specialties & licenses 1

Addresses

Other names 1

• Lifeline Pharmacy 1 Doing business as

Locations

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584576000000",
    "number": "1336775527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 OVIEDO",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785205057",
            "telephone_number": "845-283-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W TRENTON ROAD",
            "address_2": "SUITE 12",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "78539",
            "telephone_number": "956-255-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE PHARMACY 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-19",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "MOBEEN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "845-283-7474"
    },
    "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"
        }
    ]
}

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• Community/Retail Pharmacy in Edinburg, TX
• Providers in Edinburg, 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 19, 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.