CP

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

30542 Issued in TX

Legal business name

CP

Doing business as

Cardinal Pharmacy

Practice address

5309 FM 1252 W
Kilgore, TX 75662-1966

Phone

(903) 983-3372

Fax

(903) 983-3786

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Crystal Penney

Title

Owner

Phone

(903) 983-3372

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Cardinal Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466035200000",
    "number": "1750466041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5309 FM 1252 W",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756621966",
            "telephone_number": "903-983-3372",
            "fax_number": "903-983-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5309 FM 1252 W",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756621966",
            "telephone_number": "903-983-3372",
            "fax_number": "903-983-3786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2016-06-16",
        "status": "A",
        "authorized_official_last_name": "PENNEY",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-983-3372"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "30542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2159459",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "VP1428487",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardinal Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Francisco Cibele, M.D.
• Alan S Clark, MD
• CLST Home Health (Acea Home Health)
• Angie Colbert
• Country Place Village I LP
• Craig Eye Associates
• Cindy R Crye, LPC
• CVS Pharmacy Inc (CVS Pharmacy # 06925)
• Jacqueline Daves, LPA, LCDC
• Jeffrey L Davis, DDS

• Community/Retail Pharmacy in Kilgore, TX
• Providers in Kilgore, 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 Jun 16, 2016; 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.