NPIMap

Organization Active NPI

Texas Tech University Health Sciences Center

Doing business as TTUHSC Pharmacy

  • Pharmacy
  • Lubbock, TX
National Provider Identifier
1609810977
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
20678 Issued in TX
Legal business name
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Doing business as
TTUHSC Pharmacy
Practice address
3601 4TH St # 1B300
Lubbock, TX 79430
Phone
(806) 743-3270
Fax
(806) 743-3260
NPI assigned
Jun 16, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Grace M Kuo, PHD
Title
Dean, Texas Tech School of Pharmacy
Phone
(806) 356-4000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 20678 TX Primary

Addresses

Primary practice location

3601 4TH St # 1B300
Lubbock, TX 79430

Mailing address

3601 4TH St
#1A150
Lubbock, TX 79430-0002
Phone (806) 743-3270

Other identifiers 3

IdentifierTypeStateIssuer
320238MedicaidTX
20678OtherTXSTATE BOARD OF PHARMACY
323026OtherTXMEDICARE PART B IMMUNIZER

Other names 1

  • TTUHSC Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151007001957 TX Part B Supplier - Mass Immunization (Roster Biller Only) 1557599388 Practice locations: Lubbock, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2057465Ttuhsc Pharmacy3601 4TH St Mail Stop 7465 Suite 1B300, Lubbock, TX 79430Certificate of waiverApr 16, 2027

National Provider Directory

National Provider Directory
Part of
Texas Tech SCH of Med

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1400 S Coulter St
#1100
Amarillo, TX 79106
Phone (806) 356-4620

3404 4th Ave
Unit D
Canyon, TX 79015
Phone (806) 414-9650

3601 4th St
#1A150
Lubbock, TX 79430
Phone (806) 743-3270

3601 4th St
#1B300
Lubbock, TX 79430
Phone (806) 743-3270

3601 4th St
Ste 1B300
Lubbock, TX 79430

Practitioners & affiliated clinicians

Practitioners 134

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 134

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1609810977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "address_2": "#1A150",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002",
            "telephone_number": "806-743-3270",
            "fax_number": "806-743-3260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST # 1B300",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79430",
            "telephone_number": "806-743-3270",
            "fax_number": "806-743-3260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER",
        "enumeration_date": "2006-06-16",
        "last_updated": "2023-03-07",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "KUO",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DEAN, TEXAS TECH SCHOOL OF PHARMACY",
        "authorized_official_telephone_number": "806-356-4000",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "20678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "320238",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF PHARMACY",
            "identifier": "20678",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B IMMUNIZER",
            "identifier": "323026",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TTUHSC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TTUHSC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.