Jeffrey Spencer Pack, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

50411 Issued in TX

Practice address

2720 E Business 190
Copperas Cove, TX 76522-2584

Phone

(254) 542-7697

NPI assigned

Nov 6, 2020

Sex

Male

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wal-Mart Stores Texas LLC

  • Community/Retail Pharmacy
  • Copperas Cove, TX
  • NPI 1659398832
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 6, 2020.

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1467053363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 E BUSINESS 190",
            "city": "COPPERAS COVE",
            "state": "TX",
            "postal_code": "765222584",
            "telephone_number": "254-542-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 E BUSINESS 190",
            "city": "COPPERAS COVE",
            "state": "TX",
            "postal_code": "765222584",
            "telephone_number": "254-542-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "JEFFREY",
        "middle_name": "SPENCER",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "50411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Copperas Cove, TX
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.

Verify at the official NPI Registry.