NPIMap

Organization Active NPI

Medicine Man, L.P.

  • Community/Retail Pharmacy
  • Santa Fe, TX
National Provider Identifier
1376509885
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
20997 Issued in TX
Legal business name
MEDICINE MAN, L.P.
Practice address
13250 Highway 6
Santa Fe, TX 77510-7682
Phone
(409) 925-3522
Fax
(409) 925-9958
NPI assigned
Apr 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ernest H. Zost, RPH
Title
President & Ceo
Phone
(972) 860-0202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 20997 TX Primary

Addresses

Primary practice location

13250 Highway 6
Santa Fe, TX 77510-7682

Mailing address

16250 Dallas Pkwy
Suite 100
Dallas, TX 75248-2626
Phone (972) 860-0200

Other identifiers 1

IdentifierTypeStateIssuer
145138MedicaidTX

Other names 1

  • Santa Fe Medicine Man, L.P. Other name

National Provider Directory

National Provider Directory
Tax ID family
Alvin Medicine Man LP3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376509885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16250 DALLAS PKWY",
            "address_2": "SUITE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752482626",
            "telephone_number": "972-860-0200",
            "fax_number": "972-860-0298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13250 HIGHWAY 6",
            "city": "SANTA FE",
            "state": "TX",
            "postal_code": "775107682",
            "telephone_number": "409-925-3522",
            "fax_number": "409-925-9958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINE MAN, L.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZOST",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "972-860-0202",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "20997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145138",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Santa Fe Medicine Man, L.P.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Fe, TX

Sources for this page

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