MLDP of Texas LP

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY005579IR Issued in LA

Legal business name

MLDP OF TEXAS LP

Doing business as

Legends Pharmacy

Practice address

222 Bell LN Ste 5a
West Monroe, LA 71291-6303

Phone

(318) 998-3018

Fax

(318) 998-3020

NPI assigned

Sep 13, 2006

Last updated

Mar 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Angela Dipaolo, PHARMD

Title

VP of Pharmacy Operations

Phone

(210) 510-2692

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• LEGENDS PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• MLDP of Texas LP

  dba Legends Pharmacy

  • Long Term Care Pharmacy
  • San Antonio, TX
  • NPI 1538235643

  0547590457

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Legends Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• MLDP of Texas LP

  dba Legends Pharmacy

  • Long Term Care Pharmacy
  • San Antonio, TX
  • NPI 1538235643
  NPD tax ID

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Hali Havard, CPHT

  • Pharmacy Technician
  • West Monroe, LA
  • NPI 1497527600
  NPD (past)
• Amy N Pleasant, RPH

  • Pharmacist
  • West Monroe, LA
  • NPI 1962158097
  NPD (past)
• Cindy Ho Santiago

  • Pharmacist
  • West Monroe, LA
  • NPI 1346189107
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1386749760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 BLANCO RD",
            "address_2": "SUITE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166102",
            "telephone_number": "210-510-2692",
            "fax_number": "210-736-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 BELL LN STE 5A",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712916303",
            "telephone_number": "318-998-3018",
            "fax_number": "318-998-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MLDP OF TEXAS LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "DIPAOLO",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "VP OF PHARMACY OPERATIONS",
        "authorized_official_telephone_number": "210-510-2692",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "PHY005579IR",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2035341",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1210706",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LEGENDS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LEGENDS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jonann Cannon Milner
• Mindful Change, LLC
• Sarah Minter, PT, DPT
• Kelley Gatewood Mitchell, RPH
• Keri Lynn Mitchell, MA, CCC-SLP
• Mock's Pharmacy and Gifts, Inc.
• Hannah Louise Monk, MD
• Monpsych Care Professional Corporation
• Brandon Moore, M.A., CCC/SLP
• Cassidy Fay Moore

• Community/Retail Pharmacy in West Monroe, LA
• Providers in West Monroe, LA by specialty
• Community/Retail Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.