NPIMap

Organization Active NPI

Diabetes America LLC

Doing business as MedEase RX Pharmacy

  • Community/Retail Pharmacy
  • Arlington, TX
National Provider Identifier
1598163149
Registry record updated Jun 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
29636 Issued in TX
Legal business name
DIABETES AMERICA LLC
Doing business as
MedEase RX Pharmacy
Practice address
4519 Matlock Rd Ste 135a
Arlington, TX 76018-5674
Phone
(817) 855-1035
NPI assigned
Dec 15, 2014
Last updated
Jun 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2016

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

Authorized official

Name
Tammie Miskimins
Title
MGR. Licensing & Third Party
Phone
(817) 572-0009

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 29636 TX Primary

Addresses

Primary practice location

4519 Matlock Rd Ste 135a
Arlington, TX 76018-5674

Mailing address

1620 W. Northwest Hwy
Suite 100
Grapevine, TX 76051
Phone (817) 572-0009

Other identifiers 1

IdentifierTypeStateIssuer
2149257OtherPK

Other names 1

  • MedEase RX Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Diabetes America5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

4519 Matlock Rd
Ste 135A
Arlington, TX 76018
Phone (817) 855-1035

NPI Registry JSON

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

{
    "created_epoch": "1418601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467072000000",
    "number": "1598163149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 W. NORTHWEST HWY",
            "address_2": "SUITE 100",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "76051",
            "telephone_number": "817-572-0009",
            "fax_number": "817-720-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4519 MATLOCK RD STE 135A",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760185674",
            "telephone_number": "817-855-1035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES AMERICA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-15",
        "last_updated": "2016-06-28",
        "status": "A",
        "authorized_official_last_name": "MISKIMINS",
        "authorized_official_first_name": "TAMMIE",
        "authorized_official_title_or_position": "MGR. LICENSING & THIRD PARTY",
        "authorized_official_telephone_number": "817-572-0009"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "29636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2149257",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedEase RX Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.