NPIMap

Organization Active NPI

Salfiti Seagoville Pharmacy, LLC

  • Community/Retail Pharmacy
  • Seagoville, TX
National Provider Identifier
1740216464
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SALFITI SEAGOVILLE PHARMACY, LLC
Practice address
112 Hall Rd
Seagoville, TX 75159-2916
Phone
(972) 287-7070
Fax
(972) 287-8199
NPI assigned
Jun 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Authorized official

Name
Raja Salfiti
Title
Manager
Phone
(940) 627-5400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

112 Hall Rd
Seagoville, TX 75159-2916

Mailing address

112 Hall Rd
Seagoville, TX 75159-2916
Phone (972) 287-7070

Other identifiers 2

IdentifierTypeStateIssuer
2105335OtherPK
150335MedicaidTX

Other names 1

  • GIBSON DISCOUNT PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230502003164 TX Part B Supplier - Pharmacy 4981069671 Practice locations: Seagoville, TX

National Provider Directory

National Provider Directory

Locations

112 Hall Rd
Seagoville, TX 75159
Phone (972) 287-7070

Practitioners & affiliated clinicians

Practitioners 7

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": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735171200000",
    "number": "1740216464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HALL RD",
            "city": "SEAGOVILLE",
            "state": "TX",
            "postal_code": "751592916",
            "telephone_number": "972-287-7070",
            "fax_number": "972-287-8199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 HALL RD",
            "city": "SEAGOVILLE",
            "state": "TX",
            "postal_code": "751592916",
            "telephone_number": "972-287-7070",
            "fax_number": "972-287-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALFITI SEAGOVILLE PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A",
        "authorized_official_last_name": "SALFITI",
        "authorized_official_first_name": "RAJA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "940-627-5400"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2105335",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150335",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GIBSON DISCOUNT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GIBSON DISCOUNT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seagoville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; 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.