Plum Creek Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PLUM CREEK PHARMACY LLC

Practice address

4217 Benner Ste 430
Kyle, TX 78640-2555

Phone

(512) 289-0257

NPI assigned

Jan 23, 2021

Organization subpart

No

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

Authorized official

Name

Michael Boccieri, RPHNPI 1265707145

Title

Manager

Phone

(512) 289-0257

Specialties & licenses 1

Addresses

Other names 1

• Plum Creek Pharmacy Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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

• Michael Clawson Boccieri, RPH

  • Pharmacist
  • Austin, TX
  • NPI 1265707145
  NPD Authorized official

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

{
    "created_epoch": "1611360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611360000000",
    "number": "1366032302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7905 BELL MOUNTAIN DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787302818",
            "telephone_number": "512-289-0257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4217 BENNER STE 430",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786402555",
            "telephone_number": "512-289-0257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLUM CREEK PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-23",
        "last_updated": "2021-01-23",
        "certification_date": "2021-01-23",
        "status": "A",
        "authorized_official_last_name": "BOCCIERI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "512-289-0257",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Plumcreekpharmacy@gmail.com",
            "affiliation": "N",
            "endpointDescription": "pharmacy",
            "address_1": "4217 Benner Ste 430",
            "city": "Kyle",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786402555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Plum Creek Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melinda Perez
• Anh The Nhat Pham, DDS
• Physiotherapy Associates, Inc.
• Stephanie Cutler Pinson, LCSW
• Krista Plaster, LPC-A
• Plum Creek Surgery Center, LLC
• Andrea Plummer, PTA
• Stephanie Pool, M.E.S.
• Anna Poole, MSN, APRN, FNP-BC
• Bonnie Pope, FNP-C

• Community/Retail Pharmacy in Kyle, TX
• Providers in Kyle, 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 Jan 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.