Raiine'S Specialty Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

RAIINE'S SPECIALTY PHARMACY LLC

Practice address

1880 Round Rock Ave Ste 200
Round Rock, TX 78681-4085

Phone

(512) 767-1174

Fax

(512) 767-1175

NPI assigned

Jul 15, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Keerthan Kota

Title

Officer

Phone

(512) 767-1174

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1500076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709251200000",
    "number": "1356863898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 ROUND ROCK AVE STE 200",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814085",
            "telephone_number": "512-767-1174",
            "fax_number": "512-767-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 ROUND ROCK AVE STE 200",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814085",
            "telephone_number": "512-767-1174",
            "fax_number": "512-767-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAIINE'S SPECIALTY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-15",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A",
        "authorized_official_last_name": "KOTA",
        "authorized_official_first_name": "KEERTHAN",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "512-767-1174",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149821",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Round Rock, TX
• Providers in Round Rock, 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 1, 2024; 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.