Individual provider Active NPI

Prince Chimezie Ogbonna, PHARMACIST

  • Pharmacist
  • Fort Worth, TX
National Provider Identifier
1629196662
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
52139 Issued in TX
Practice address
6080 S Hulen St Ste 320
Fort Worth, TX 76132-2634
Phone
(682) 250-2229
Fax
(682) 224-3820
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PR4609 ME
Pharmacist 183500000X PH22660 MA
Pharmacist 183500000X 52139 TX Primary

Addresses

Primary practice location

6080 S Hulen St Ste 320
Fort Worth, TX 76132-2634

Mailing address

6080 S Hulen St Ste 320
Fort Worth, TX 76132-2634
Phone (682) 250-2229

Other identifiers 4

IdentifierTypeStateIssuer
52139OtherTXTEXAS BOARD OF PHARMACY FOR PHARMACIST
PH22660OtherGARPH LICENSE NUMBER
150302MedicaidTX
PR4609OtherMERPH LICENSE NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.macprincepharmacy.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PH22660MAMDPharmacist
PR4609MEMDPharmacist
52139TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Machias Friendly Pharmacy Current Accepting new patients
Machias Friendly Pharmacy Current Accepting new patients
Macprince Pharmacy Inc. CurrentSince Mar 1, 2020 Accepting new patients

Locations

8 Old County Rd
Marshfield, ME 04654
Phone (207) 255-6400

3401 Altamesa Blvd
Ste 122
Fort Worth, TX 76133
Phone (682) 250-2229

6080 S Hulen St
Ste 320
Fort Worth, TX 76132
Phone (682) 250-2229

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1629196662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6080 S HULEN ST STE 320",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761322634",
            "telephone_number": "682-250-2229",
            "fax_number": "682-224-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 S HULEN ST STE 320",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761322634",
            "telephone_number": "682-250-2229",
            "fax_number": "682-224-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBONNA",
        "first_name": "PRINCE",
        "middle_name": "CHIMEZIE",
        "name_prefix": "Mr.",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ME",
            "license": "PR4609",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH22660",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "52139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF PHARMACY FOR PHARMACIST",
            "identifier": "52139",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RPH LICENSE NUMBER",
            "identifier": "PH22660",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RPH LICENSE NUMBER",
            "identifier": "PR4609",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.macprincepharmacy.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6080 S Hulen St Ste 320",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761322634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.