Roberds Specialty Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

30619 Issued in TX

Legal business name

ROBERDS SPECIALTY PHARMACY LLC

Doing business as

Roberds Pharmacy

Practice address

2510 S Loop 336 W Ste 105
Conroe, TX 77304-3737

Phone

(936) 756-4254

Fax

(936) 756-6252

NPI assigned

Jul 22, 2006

Organization subpart

No

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

Authorized official

Name

Van TranNPI 1033403431

Title

Owner

Phone

(936) 756-4254

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Roberds Pharmacy Doing business as

Locations

Practitioners 1

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

• Van Tran, PHARMD, RPH

  • Pharmacist
  • Conroe, TX
  • NPI 1033403431
  NPD Authorized official

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606435200000",
    "number": "1619998663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 MEDICAL CENTER BLVD STE 130",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042928",
            "telephone_number": "936-756-4254",
            "fax_number": "936-756-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 S LOOP 336 W STE 105",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043737",
            "telephone_number": "936-756-4254",
            "fax_number": "936-756-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERDS SPECIALTY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-11-27",
        "certification_date": "2020-11-27",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "VAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-756-4254"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "30619",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148513",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2156162",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roberds Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Roberds Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wamiq Rizwan, DPT
• Rmac Village Pharmacy Dba Village Pharmacy
• RNL Berwick Im
• Lauren Robbins, OTR
• Shelby L Robbins, LVN
• Dillan Paul Roberson
• Erin Roberts, CPNP-PC
• Richard Royston Roberts, M.D.
• Shalisha Allison Roberts
• Sophie Roberts, PT, DPT, CPRCS

• Community/Retail Pharmacy in Conroe, TX
• Providers in Conroe, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.