Organization Active NPI

MPP Pharmacy Inc.

Doing business as Super Mercado Pharmacy

  • Pharmacy
  • Midland, TX
National Provider Identifier
1609887298
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
MPP PHARMACY INC.
Doing business as
Super Mercado Pharmacy
Practice address
2208 N Big Spring St
Midland, TX 79705
Phone
(432) 682-9501
Fax
(432) 682-9497
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
Dhairant Patel
Title
Officer
Phone
(432) 682-9501

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X 25536 TX

Addresses

Primary practice location

2208 N Big Spring St
Midland, TX 79705

Mailing address

2208 N Big Spring St
Midland, TX 79705
Phone (432) 682-9501

Other identifiers 2

IdentifierTypeStateIssuer
145797MedicaidTX
2097313OtherPK

Other names 1

  • Super Mercado Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
MPP Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2208 N Big Spring St
Midland, TX 79705
Phone (432) 682-9501

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1609887298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 N BIG SPRING ST",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "79705",
            "telephone_number": "432-682-9501",
            "fax_number": "432-682-9497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2208 N BIG SPRING ST",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "79705",
            "telephone_number": "432-682-9501",
            "fax_number": "432-682-9497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MPP PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "DHAIRANT",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "432-682-9501"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "25536",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145797",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2097313",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Super Mercado Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.