P & S Rexall Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

10046 Issued in TX

Legal business name

P & S REXALL PHARMACY INC

Practice address

829 N Main St
Corsicana, TX 75110-3048

Phone

(903) 874-5691

Fax

(903) 872-1925

NPI assigned

Sep 14, 2006

Organization subpart

No

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

Authorized official

Name

Trena Weidmann

Title

Owner

Phone

(903) 874-5691

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• P & S PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684368000000",
    "number": "1689779456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 957",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751510957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 N MAIN ST",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751103048",
            "telephone_number": "903-874-5691",
            "fax_number": "903-872-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P & S REXALL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A",
        "authorized_official_last_name": "WEIDMANN",
        "authorized_official_first_name": "TRENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-874-5691"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "10046",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2102884",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142376",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "P & S PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "P & S PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kent Olsen, DPM
• Charles D Osborn, MD
• Kathryn Ottmo, MAC
• Tiffany Ozymy
• P & S Rexall Pharmacy Inc
• P & S Rexall Pharmacy,Inc
• Amanda Pajouh, DPM
• Matthew David Parker, OD
• James Harris Parks II, CRNA
• Mary M Parks, LCDC

• All providers in Corsicana, TX
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; 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.