Clinical Specialty Infusions of Dallas LLC
Organization Active NPI Home Infusion Therapy Pharmacy · Nash, TX
NPI 1396288338 · NPPES record last updated May 8, 2024
Key facts
- NPI
- 1396288338
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Infusion Therapy Pharmacy 3336H0001X
- License
- OSO2790 (AR)
- Legal business name
- CLINICAL SPECIALTY INFUSIONS OF DALLAS LLC
- Practice address
- 459 E New Boston Rd
Nash, TX 75569-2715 - Phone
- (833) 569-1005
- Fax
- (430) 200-4889
- NPI assigned
- Nov 23, 2016
- Organization subpart
- No
Authorized official
- Name
- James Lynn Sheets, PHARM.D.
- Title
- Chief Executive Officer
- Phone
- (833) 569-1005
Other NPIs with the same Medicare PAC ID 2
Subparts reporting this organization as parent 1
Practitioners 3
-
Jack Lemley Jr., PHARM.D.
-
Alisha Smith, PHARM D
-
Jordan Michael Bruns, RPH, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170508002486 | TX | DME Supplier - Pharmacy |
2567749112 | Practice locations: Nash, TX |
| O20230425001957 | TX | Part B Supplier - Pharmacy | 2567749112 | Practice locations: Nash, TX |
National Provider Directory
Locations
5429 E Beaumont Center Blvd
Ste 820
Tampa, FL 33634
Phone (833) 569-1005
459 E New Boston Rd
Nash, TX 75569
Phone (833) 569-1005
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Infusion Agency | 251F00000X | |||
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | A9-0002021 | DE | |
| Compounding Pharmacy | 3336C0004X | Y007261 | AZ | |
| Home Infusion Therapy Pharmacy | 3336H0001X | 31100 | TX | |
| Home Infusion Therapy Pharmacy | 3336H0001X | PH00004457 | NM | |
| Home Infusion Therapy Pharmacy | 3336H0001X | 054020523 | IL | |
| Home Infusion Therapy Pharmacy | 3336H0001X | OSO2790 | AR | Yes |
| Home Infusion Therapy Pharmacy | 3336H0001X | NR-51359 | WY | |
| Home Infusion Therapy Pharmacy | 3336H0001X | 64002405A | IN | |
| Specialty Pharmacy | 3336S0011X | OSP.0006979 | CO | |
| Specialty Pharmacy | 3336S0011X |
Addresses
Primary practice location
459 E New Boston Rd
Nash, TX 75569-2715
Mailing address
459 E New Boston Rd
Nash, TX 75569-2715
Phone (833) 569-1005
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2160928 | Other | PK | |
| 3951113 | Medicaid | TX | |
| 149579 | Medicaid | TX | |
| 220687407 | Medicaid | AR |
Other names
- CSI Pharmacy
Other providers in Nash, TX
- Joyce Edlyne Chima Bom
- Clinical Specialty Infusions of Dallas LLC
- Kimberly Sue Espinoza
- Evergreen Presbyterian Ministries of Texas, Inc.
- Jessica Renee Trichel O D PLLC
- Ayvee Lavender
- Kelsey D McCain
All providers in Nash, TX · Home Infusion Therapy Pharmacy in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.