NPIMap

Organization Active NPI

Legacy Apothecary LP

Doing business as ReNue Rx #12- LTC

  • Long Term Care Pharmacy
  • Coppell, TX
National Provider Identifier
1730947102
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
LEGACY APOTHECARY LP
Doing business as
ReNue Rx #12- LTC
Practice address
150 N Coppell Rd Ste Pharmacy
Coppell, TX 75019-2293
Phone
(972) 371-0067
NPI assigned
Mar 11, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Authorized official

Name
Raj Milan ChhaduaNPI 1316273956
Title
Managing Partner
Phone
(469) 294-2001

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

150 N Coppell Rd Ste Pharmacy
Coppell, TX 75019-2293

Mailing address

PO Box 2735
Frisco, TX 75034-0051

Other names 1

  • ReNue Rx #12- LTC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Legacy Apothecary LP2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

150 N Coppell Rd
Coppell, TX 75019
Phone (469) 213-3659

Practitioners & affiliated clinicians

Practitioners 5

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": "1710115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710115200000",
    "number": "1730947102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2735",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750340051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N COPPELL RD STE PHARMACY",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750192293",
            "telephone_number": "972-371-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY APOTHECARY LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A",
        "authorized_official_last_name": "CHHADUA",
        "authorized_official_first_name": "RAJ",
        "authorized_official_middle_name": "MILAN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "469-294-2001"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ReNue Rx #12- LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coppell, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.