Prosper Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

29623 Issued in TX

Legal business name

PROSPER PHARMACY LLC

Doing business as

Prosper Pharmacy

Practice address

1000 Preston Rd N
Suite 10
Prosper, TX 75078-8779

Phone

(214) 338-4010

Fax

(214) 338-4011

NPI assigned

Oct 31, 2014

Last updated

Dec 8, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adi Gelli

Title

Corporate Manager

Phone

(214) 338-4010

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Prosper Pharmacy Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keerthi Ananthula, RPH

  • Pharmacist
  • Prosper, TX
  • NPI 1871162883
  NPD (past)
• Jairam Gorle, RPH

  • Pharmacist
  • Prosper, TX
  • NPI 1407183387
  NPD (past)

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1740685890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 PRESTON RD N",
            "address_2": "SUITE 10",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750788779",
            "telephone_number": "214-338-4010",
            "fax_number": "214-338-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PRESTON RD N",
            "address_2": "SUITE 10",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750788779",
            "telephone_number": "214-338-4010",
            "fax_number": "214-338-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPER PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-31",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "GELLI",
        "authorized_official_first_name": "ADI",
        "authorized_official_title_or_position": "CORPORATE MANAGER",
        "authorized_official_telephone_number": "214-338-4010"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "29623",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2148612",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prosper Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Prosper, TX
• Providers in Prosper, 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 Dec 8, 2014; 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.