Organization Active NPI

Prodigious Industries LLC

Doing business as Kearney Park Pharmacy

  • Long Term Care Pharmacy
  • Mesquite, TX
National Provider Identifier
1336867225
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
PRODIGIOUS INDUSTRIES LLC
Doing business as
Kearney Park Pharmacy
Practice address
3224 Gus Thomasson Rd
Mesquite, TX 75150-4004
Phone
(972) 329-1168
Fax
(972) 329-1436
NPI assigned
Aug 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Authorized official

Name
Fronce BarnesNPI 1265661284
Title
Pharmacist/Owner
Phone
(972) 740-7180

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

3224 Gus Thomasson Rd
Mesquite, TX 75150-4004

Mailing address

3224 Gus Thomasson Rd
Mesquite, TX 75150-4004
Phone (972) 329-1168

Other names 1

  • Kearney Park Pharmacy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1660694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1336867225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3224 GUS THOMASSON RD",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751504004",
            "telephone_number": "972-329-1168",
            "fax_number": "972-329-1436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3224 GUS THOMASSON RD",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751504004",
            "telephone_number": "972-329-1168",
            "fax_number": "972-329-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGIOUS INDUSTRIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-17",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "FRONCE",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "972-740-7180"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kearney Park Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.