Active NPI
SLG Pharmacy LLC
Doing business as Laurel Heights Pharmacy
- Specialty Pharmacy
- San Antonio, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialty Pharmacy
- Legal business name
- SLG PHARMACY LLC
- Doing business as
- Laurel Heights Pharmacy
- Practice address
- 2602 N Main Ave
San Antonio, TX 78212-2919 - Phone
- (210) 881-0890
- Fax
- (210) 569-6464
- NPI assigned
- Oct 24, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Prem Kalidindi, RPH
- Title
- Managing Member
- Phone
- (210) 881-0890
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialty Pharmacy | 3336S0011X | Primary |
Addresses
Primary practice location
2602 N Main Ave
San Antonio, TX 78212-2919
Mailing address
PO Box 12929
San Antonio, TX 78212-0929
Phone (917) 769-8014
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 146440 | Medicaid | TX |
Other names 1
- Laurel Heights Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Laurel Heights Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
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.
-
- Pharmacist
- Irving, TX
- NPI 1699102699
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540339200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1540339200000",
"number": "1710454186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12929",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782120929",
"telephone_number": "917-769-8014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2602 N MAIN AVE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782122919",
"telephone_number": "210-881-0890",
"fax_number": "210-569-6464"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SLG PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-10-24",
"last_updated": "2018-10-24",
"status": "A",
"authorized_official_last_name": "KALIDINDI",
"authorized_official_first_name": "PREM",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "210-881-0890",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336S0011X",
"taxonomy_group": "",
"desc": "Pharmacy, Specialty Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "146440",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Laurel Heights Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.