Procare Specialty Medicine, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PROCARE SPECIALTY MEDICINE, LLC

Practice address

2698 N Galloway Ave Ste 108
Mesquite, TX 75150-6390

Phone

(469) 913-6090

Fax

(214) 853-5761

NPI assigned

Mar 2, 2021

Organization subpart

No

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

Authorized official

Name

Ebin Thomas Sunny

Title

Officer

Phone

(469) 913-6090

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614643200000",
    "number": "1467047456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 832042",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750832042",
            "telephone_number": "469-913-6090",
            "fax_number": "214-853-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2698 N GALLOWAY AVE STE 108",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506390",
            "telephone_number": "469-913-6090",
            "fax_number": "214-853-5761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE SPECIALTY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "SUNNY",
        "authorized_official_first_name": "EBIN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "469-913-6090"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Mesquite, TX
• Providers in Mesquite, 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 Mar 2, 2021; 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.