Active NPI
White Cross RX LLC
Doing business as White Cross Pharmacy
- Pharmacy
- San Antonio, TX
National Provider Identifier
1457496473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 10309
- Legal business name
- WHITE CROSS RX LLC
- Doing business as
- White Cross Pharmacy
- Practice address
- 1303 McCullough Ave
Suite 128
San Antonio, TX 78212-5609 - Phone
- (210) 227-7207
- Fax
- (210) 227-4763
- NPI assigned
- Feb 20, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Praveen Daida
- Title
- Managing Member
- Phone
- (972) 215-9072
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 10309 | TX | Primary |
Addresses
Primary practice location
1303 McCullough Ave
Suite 128
San Antonio, TX 78212-5609
Mailing address
1303 McCullough Ave
Suite 128
San Antonio, TX 78212-5609
Phone (210) 227-7207
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 142486 | Medicaid | TX |
Other names 1
- White Cross Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- John M Mohrmann Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
Locations
1303 McCullough Ave
Ste 128
San Antonio, TX 78212
Phone (210) 227-7207
1303 McCullough Ave
Ste 1
San Antonio, TX 78212
Phone (210) 227-7207
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1577923200000",
"number": "1457496473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1303 MCCULLOUGH AVE",
"address_2": "SUITE 128",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782125609",
"telephone_number": "210-227-7207",
"fax_number": "210-227-4763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1303 MCCULLOUGH AVE",
"address_2": "SUITE 128",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782125609",
"telephone_number": "210-227-7207",
"fax_number": "210-227-4763"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WHITE CROSS RX LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-20",
"last_updated": "2020-01-02",
"certification_date": "2020-01-02",
"status": "A",
"authorized_official_last_name": "DAIDA",
"authorized_official_first_name": "PRAVEEN",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "972-215-9072"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "TX",
"license": "10309",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "142486",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "White Cross Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.