Pharmblue LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

035289 Issued in NY

Legal business name

PHARMBLUE LLC

Practice address

5700 Granite Pkwy Ste 425
Plano, TX 75024-6648

Phone

(469) 592-2011

NPI assigned

Oct 7, 2015

Organization subpart

No

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

Authorized official

Name

Carl Cody Colquitt

Title

Cfo

Phone

(469) 592-2011

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• PharmBlue LLC Doing business as

Tax ID family

Avita2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Pharmblue LLC

  • Community/Retail Pharmacy
  • Philadelphia, PA
  • NPI 1386984771
  NPD tax ID

Locations

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1780055434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10604 COURSEY BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708164015",
            "telephone_number": "469-592-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 GRANITE PKWY STE 425",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750246648",
            "telephone_number": "469-592-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMBLUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "COLQUITT",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "CODY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "469-592-2011"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP482599",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "035289",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028110910002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154646",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PharmBlue LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily A Phan, PA-C
• Oanh Phan, PHARM D
• Thanh Phan, APRN
• Thuy Lynh Phan, D.O.
• Mary Frances Phares, FNP-C
• Bailey Phelan, M.A., SLP
• Jada R Pherribo
• Philip D. Korenman MD
• Jiffy Ann Philip, PHARM.D
• Terry V Philip

• Community/Retail Pharmacy in Plano, TX
• Providers in Plano, 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 27, 2024; 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.