NPIMap

Organization Active NPI

Centerwell Pharmacy, Inc.

Doing business as Humana Pharmacy, Inc.

  • Pharmacy
  • Live Oak, TX
National Provider Identifier
1508310772
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
30954 Issued in TX
Legal business name
CENTERWELL PHARMACY, INC.
Doing business as
Humana Pharmacy, Inc.
Practice address
12602 Toepperwein Rd
Suite 100
Live Oak, TX 78233-3269
Phone
(210) 672-6510
NPI assigned
Aug 5, 2016
Last updated
May 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Authorized official

Name
Sean Lysinger
Title
VP
Phone
(502) 580-2376

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 30954 TX Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

12602 Toepperwein Rd
Suite 100
Live Oak, TX 78233-3269

Mailing address

12602 Toepperwein Rd
Suite 100
Live Oak, TX 78233-3269
Phone (210) 672-6510

Other names 1

  • Humana Pharmacy, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191009003527 TX Part B Supplier - Pharmacy 9739233743 Practice locations: Live Oak, TX

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 20

National Provider Directory

National Provider Directory
Tax ID family
Humana Pharmacy- Homestead47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

Organizations that report the same tax identification number in the National Provider Directory.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1508310772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12602 TOEPPERWEIN RD",
            "address_2": "SUITE 100",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333269",
            "telephone_number": "210-672-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12602 TOEPPERWEIN RD",
            "address_2": "SUITE 100",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333269",
            "telephone_number": "210-672-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERWELL PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-05",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A",
        "authorized_official_last_name": "LYSINGER",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "502-580-2376"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "30954",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Humana Pharmacy, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Live Oak, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.