South Austin Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28387 Issued in TX

Legal business name

SOUTH AUSTIN PHARMACY LLC

Doing business as

South Austin Pharmacy

Practice address

4203A James Casey St
Austin, TX 78745-1108

Phone

(512) 383-9000

Fax

(512) 383-9006

NPI assigned

Dec 19, 2012

Last updated

Feb 12, 2013By 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

Haider Al-Wishah

Title

Pharmacist in Charge

Phone

(512) 708-0370

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• South Austin Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360627200000",
    "number": "1801132873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4203A JAMES CASEY ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451108",
            "telephone_number": "512-383-9000",
            "fax_number": "512-383-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203A JAMES CASEY ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451108",
            "telephone_number": "512-383-9000",
            "fax_number": "512-383-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH AUSTIN PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-19",
        "last_updated": "2013-02-12",
        "status": "A",
        "authorized_official_last_name": "AL-WISHAH",
        "authorized_official_first_name": "HAIDER",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "512-708-0370"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "28387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801132873",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5907893",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Austin Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Austin Medical Clinic PA
• South Austin Microendodontics
• South Austin OB-GYN
• South Austin Oral Surgery
• South Austin Orthopaedic Clinic PA
• South Austin Rehabilitation & Wound Clinic Inc
• South Austin Senior Care LLC (HALO Senior Care LLC)
• South Austin Speech & Language, PLLC
• South Austin Surgery Center LTD (Surgicare of South Austin)
• South Austin Therapy Group, Inc (South Austin Therapy)

• Community/Retail Pharmacy in Austin, TX
• Providers in Austin, 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 Feb 12, 2013; 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.