NPIMap

Organization Active NPI

Minyard Food Stores Inc.

  • Community/Retail Pharmacy
  • Ft Worth, TX
National Provider Identifier
1740367614
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
19060 Issued in TX
Legal business name
MINYARD FOOD STORES INC.
Practice address
4245 E Berry St
Ft Worth, TX 76105-5002
Phone
(817) 536-4550
Fax
(817) 536-4617
NPI assigned
Oct 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Authorized official

Name
Mr. Michael D. Byars
Title
President/Ceo
Phone
(972) 393-8700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 19060 TX Primary

Addresses

Primary practice location

4245 E Berry St
Ft Worth, TX 76105-5002

Mailing address

4245 E Berry St
Ft Worth, TX 76105-5002
Phone (817) 536-4550

Other identifiers 2

IdentifierTypeStateIssuer
464208MedicaidTX
4500927OtherTXNABP #

Other names 1

  • Minyard Pharmacy #33 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Minyard Food Stores Inc32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

Locations

4245 E Berry St
Ft Worth, TX 76105
Phone (817) 536-4550

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1740367614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4245 E BERRY ST",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761055002",
            "telephone_number": "817-536-4550",
            "fax_number": "817-536-4617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4245 E BERRY ST",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761055002",
            "telephone_number": "817-536-4550",
            "fax_number": "817-536-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINYARD FOOD STORES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "BYARS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "972-393-8700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "19060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "464208",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP #",
            "identifier": "4500927",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Minyard Pharmacy #33",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ft Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.