Organization Active NPI

Jsa Healthcare Services LLC

  • Pharmacy
  • San Antonio, TX
National Provider Identifier
1730833310
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
JSA HEALTHCARE SERVICES LLC
Practice address
19239 Stone Oak Pkwy Ste 103
San Antonio, TX 78258-3471
Phone
(210) 314-6464
Fax
(210) 314-6465
NPI assigned
Feb 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Authorized official

Name
Lubna AlghoulNPI 1417468414
Title
Manager
Phone
(561) 305-3648

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

19239 Stone Oak Pkwy Ste 103
San Antonio, TX 78258-3471

Mailing address

3035 Fall Crest Dr
San Antonio, TX 78247-3235
Phone (561) 305-3648

Other identifiers 1

IdentifierTypeStateIssuer
34147OtherTXTEXAS STATE BOARD OF PHARMACY

Other names 1

  • EVOLVE SPECIALTY PHARMACY & WELLNESS Doing business as

National Provider Directory

National Provider Directory

Locations

19239 Stone Oak Pkwy
Ste 103
San Antonio, TX 78258
Phone (210) 314-6464

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1730833310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 FALL CREST DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782473235",
            "telephone_number": "561-305-3648",
            "fax_number": "210-314-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19239 STONE OAK PKWY STE 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583471",
            "telephone_number": "210-314-6464",
            "fax_number": "210-314-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JSA HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A",
        "authorized_official_last_name": "ALGHOUL",
        "authorized_official_first_name": "LUBNA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-305-3648"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF PHARMACY",
            "identifier": "34147",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EVOLVE SPECIALTY PHARMACY & WELLNESS",
            "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 Mar 15, 2022; 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.