MLB Pharmacy LLC

Primary specialty

Home Infusion AgencyTaxonomy code 251F00000X

Legal business name

MLB PHARMACY LLC

Practice address

11 W Beauregard Ave
San Angelo, TX 76903-5832

Phone

(325) 777-1423

Fax

(325) 777-1430

NPI assigned

Sep 20, 2021

Organization subpart

No

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

Authorized official

Name

Micah Pratt, PHARMD

Title

Owner

Phone

(325) 777-1423

Specialties & licenses 4

Addresses

Other names 1

• Vital Care Infusion Services Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1780354852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 W BEAUREGARD AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035832",
            "telephone_number": "806-548-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 W BEAUREGARD AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035832",
            "telephone_number": "325-777-1423",
            "fax_number": "325-777-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MLB PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-20",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "PRATT",
        "authorized_official_first_name": "MICAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "325-777-1423",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vital Care Infusion Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vital Care Infusion Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kyle Mills, D.O.
• Joe A Mims, MD
• Mindfulwayz, PLLC
• Ashley Minor, FNP-BC
• Mitchell County Hospital Distict
• Stephine Nicole Mogg
• Zoya Moghal, M.D
• Carolyn Ramona Molina
• Tanyaradzwa Mombeyarara
• Orloff Monaghan, MD

• Home Infusion Agency in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Home Infusion Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.