Panacea Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

27904 Issued in TX

Legal business name

PANACEA PHARMACY LLC

Doing business as

Panacea RX Pharmacy

Practice address

1050 N Westmoreland Rd Ste 314
Dallas, TX 75211-2444

Phone

(214) 339-2352

Fax

(214) 330-2624

NPI assigned

Feb 21, 2012

Last updated

May 14, 2012By 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

Manoj ChackoNPI 1720968670

Title

Owner

Phone

(972) 369-5589

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• PANACEA RX PHARMACY Doing business as

Practitioners 1

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.

• Manoj Chacko, BS

  • Pharmacist
  • Dallas, TX
  • NPI 1720968670
  NPD Authorized official

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336953600000",
    "number": "1447523584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 N WESTMORELAND RD",
            "address_2": "SUITE 314",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752112444",
            "telephone_number": "214-339-2352",
            "fax_number": "214-330-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 N WESTMORELAND RD STE 314",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752112444",
            "telephone_number": "214-339-2352",
            "fax_number": "214-330-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANACEA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-21",
        "last_updated": "2012-05-14",
        "status": "A",
        "authorized_official_last_name": "CHACKO",
        "authorized_official_first_name": "MANOJ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-369-5589"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "27904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0146549",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5905217",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PANACEA RX PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Evelyn Tiffany Pan, MD
• Ian Pan, MD
• Shannon Amy Pan, MD
• Thoris Pan, MD
• William Weifan Pan, MD
• Panacea Therapy Solutions PLLC
• Nariman Panahi
• Daria Panahy, AGACNP-BC
• Lindsay Panbechi
• Anandkumar Panchal, APRN

• Community/Retail Pharmacy in Dallas, TX
• Providers in Dallas, 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 May 14, 2012; 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.