Killion'S Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

01734 Issued in TX

Legal business name

KILLION'S PHARMACY, LLC

Practice address

396 W Texas Ave
Waskom, TX 75692-9113

Phone

(903) 687-2525

Fax

(903) 687-2526

NPI assigned

Oct 20, 2006

Organization subpart

No

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

Authorized official

Name

Rosa RivasNPI 1831710177

Title

Owner/Pic

Phone

(903) 687-2525

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Killion's Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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

• Rosa Rivas, PHARM.D.

  • Pharmacist
  • Waskom, TX
  • NPI 1831710177
  NPD Authorized official

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1700968583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 687",
            "city": "WASKOM",
            "state": "TX",
            "postal_code": "756920687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 W TEXAS AVE",
            "city": "WASKOM",
            "state": "TX",
            "postal_code": "756929113",
            "telephone_number": "903-687-2525",
            "fax_number": "903-687-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KILLION'S PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A",
        "authorized_official_last_name": "RIVAS",
        "authorized_official_first_name": "ROSA",
        "authorized_official_title_or_position": "OWNER/PIC",
        "authorized_official_telephone_number": "903-687-2525"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "01734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143359",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2099384",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Killion's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Killion's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gwenvolk Infocus Inc
• Gwenvolkinfocus Inc
• Alisha Denise Head, COTA
• Marcellus Perris Henderson
• Shannon Griffin Johnson, CCC-SLP
• Mad Dog Enterprises LP
• Veronica Rachee McCray, LVN
• McEt-Waskom Limited Liability Company
• Frank McIlwain, O.D.
• Gwendolyn L McVey, MA, CCC-SLP

• Community/Retail Pharmacy in Waskom, TX
• Providers in Waskom, 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 Jun 12, 2025; 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.