Progressive Pharma LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

29069 Issued in TX

Legal business name

PROGRESSIVE PHARMA LLC

Doing business as

Altus Pharmacy

Practice address

1535 West Loop S
Suite 322
Houston, TX 77027-9512

Phone

(972) 432-6550

Fax

(214) 261-2217

NPI assigned

Sep 15, 2014

Last updated

Jan 12, 2015By 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

Amir Mortazavi

Title

Authorized Offical

Phone

(972) 432-6550

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Altus Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1410739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421020800000",
    "number": "1457752032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5710 LBJ FWY",
            "address_2": "SUITE 325",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752406324",
            "telephone_number": "972-432-6550",
            "fax_number": "214-261-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 WEST LOOP S",
            "address_2": "SUITE 322",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770279512",
            "telephone_number": "972-432-6550",
            "fax_number": "214-261-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE PHARMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-15",
        "last_updated": "2015-01-12",
        "status": "A",
        "authorized_official_last_name": "MORTAZAVI",
        "authorized_official_first_name": "AMIR",
        "authorized_official_title_or_position": "AUTHORIZED OFFICAL",
        "authorized_official_telephone_number": "972-432-6550"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "29069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2147410",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Altus Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Houston, TX
• Providers in Houston, 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 Jan 12, 2015; 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.