NPIMap

Organization Active NPI

Mission Hospital Inc

Doing business as Mission Regional Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Mission, TX
National Provider Identifier
1669005740
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MISSION HOSPITAL INC
Doing business as
Mission Regional Outpatient Pharmacy
Practice address
900 S Bryan Rd
Mission, TX 78572-6613
Phone
(956) 323-9106
Fax
(956) 323-9102
NPI assigned
Feb 18, 2020
Last updated
Feb 18, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
MISSION HOSPITAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Authorized official

Name
Lester Edward Surrock, CPA
Title
Chief Financial Officer
Phone
(956) 323-9106

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

900 S Bryan Rd
Mission, TX 78572-6613

Mailing address

900 S Bryan Rd
Mission, TX 78572-6613
Phone (956) 323-9106

Other names 1

  • Mission Regional Outpatient Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200327000795 TX Part B Supplier - Pharmacy 0042270563 Practice locations: Mission, TX

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Mission Hospital Crnas2 organizations share this tax ID, including this one
Part of
Mission Hospital Crnas

Other organizations with this tax ID 1

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

Member of 1

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

900 S Bryan Rd
Ste 101
Mission, TX 78572
Phone (956) 598-7050

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581984000000",
    "number": "1669005740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S BRYAN RD",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785726613",
            "telephone_number": "956-323-9106",
            "fax_number": "956-323-9102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S BRYAN RD",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785726613",
            "telephone_number": "956-323-9106",
            "fax_number": "956-323-9102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MISSION HOSPITAL INC",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A",
        "authorized_official_last_name": "SURROCK",
        "authorized_official_first_name": "LESTER",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "956-323-9106",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission Regional Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mission, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.