Burleson Pharmacy LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

BURLESON PHARMACY LLC

Practice address

344 SW Wilshire Blvd Ste P
Burleson, TX 76028-5343

Phone

(817) 720-5555

Fax

(817) 720-5554

NPI assigned

Feb 18, 2020

Organization subpart

No

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

Authorized official

Name

Mahathi Kankanala, PHARM DNPI 1942805452

Title

Pharmacy Manager

Phone

(817) 720-5555

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

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

• Mahathi Kankanala

  • Pharmacist
  • Burleson, TX
  • NPI 1942805452
  NPD Authorized official
• Frank Paul Jircik, MD

  • Internal Medicine Physician
  • Burleson, TX
  • NPI 1497711840
  NPD

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": "1700419769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 SW WILSHIRE BLVD STE P",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760285343",
            "telephone_number": "817-720-5555",
            "fax_number": "817-720-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 SW WILSHIRE BLVD STE P",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760285343",
            "telephone_number": "817-720-5555",
            "fax_number": "817-720-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURLESON PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A",
        "authorized_official_last_name": "KANKANALA",
        "authorized_official_first_name": "MAHATHI",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "817-720-5555",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Burleson Moders Dentistry, PC
• Burleson Nursing & Rehab Center, Inc
• Burleson Pediatric Dental Center LLC
• Burleson Pediatric Dentistry
• Burleson Pharmacy LLC
• Austin R Burnett, FNP-C
• Bryan Lynn Butler, LPC, LCDC
• Anthony Caballero
• Jose Calderon, PA-C
• Sarah Call

• Pharmacy in Burleson, TX
• Providers in Burleson, TX by specialty
• Pharmacy in Texas

• 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.