Issifu Tenii

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Practice address

11203 Lake June Rd Ste 206
Balch Springs, TX 75180-1219

Phone

(214) 391-7441

Fax

(214) 391-7443

NPI assigned

Mar 19, 2019

Last updated

Mar 19, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake June Pharmacy LLC

  dba Lake June Pharmacy

  • Community/Retail Pharmacy
  • Balch Springs, TX
  • NPI 1366089815
  NPD Authorized official

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1770042772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11203 LAKE JUNE RD STE 206",
            "city": "BALCH SPRINGS",
            "state": "TX",
            "postal_code": "751801219",
            "telephone_number": "214-391-7441",
            "fax_number": "214-391-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11203 LAKE JUNE RD STE 206",
            "city": "BALCH SPRINGS",
            "state": "TX",
            "postal_code": "751801219",
            "telephone_number": "214-391-7441",
            "fax_number": "214-391-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENII",
        "first_name": "ISSIFU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abortah@hotmail.com",
            "affiliation": "N",
            "address_1": "11203 Lake June Rd Ste 206",
            "city": "Balch Springs",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751801219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Community/Retail Pharmacy in Balch Springs, TX
• Providers in Balch Springs, 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 Mar 19, 2019; 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.