Life Specialty Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

LIFE SPECIALTY PHARMACY, INC.

Practice address

949 W. Kearney St.
Suite 107
Mesquite, TX 75149

Phone

(972) 681-5959

NPI assigned

Mar 21, 2019

Organization subpart

No

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

Authorized official

Name

Shaji Daniel

Title

Director

Phone

(972) 681-5959

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Ann George, PHARM. D

  • Pharmacist
  • Mesquite, TX
  • NPI 1679114086
  NPD (past)

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579824000000",
    "number": "1720548118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18770 LBJ FWY STE 200",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 W. KEARNEY ST.",
            "address_2": "SUITE 107",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "75149",
            "telephone_number": "972-681-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SPECIALTY PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-21",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A",
        "authorized_official_last_name": "DANIEL",
        "authorized_official_first_name": "SHAJI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "972-681-5959"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150116",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Kay Lewallen, FNP-BC
• Amber Nicole Lewis
• Zakymbria Lewis
• Liberty Dialysis - Mesquite LLC (Premier Dialysis - Mesquite)
• Paul E Liechty, D.C.
• Lifecare Virtual Home Health LLC (LifeCare Virtual Home Health)
• Lighthouse Behavioral Wellness Center
• Lim Healthcare Inc
• Anjelia Lincoln-Graham
• Lisa L Swanson MD Dba Mesquite Pediatric Associates

• Community/Retail Pharmacy in Mesquite, TX
• Providers in Mesquite, 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 Jan 24, 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.