Individual provider Active NPI

George Layne Vannoy, RPH

  • Pharmacist
  • Palestine, TX
National Provider Identifier
1801454020
Registry record updated Jun 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26160 Issued in TX
Practice address
101 Medical Dr
Palestine, TX 75801-4781
Phone
(903) 729-3100
Fax
(903) 729-3144
NPI assigned
Jun 3, 2019
Last updated
Jun 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 26160 TX Primary

Addresses

Primary practice location

101 Medical Dr
Palestine, TX 75801-4781

Mailing address

101 Medical Dr
Palestine, TX 75801-4781
Phone (903) 729-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
26160TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Palestine Pharmacy LLC CurrentSince Sep 15, 2019 Accepting new patients
Palestine Pharmacy LLC Current Accepting new patients

Locations

101 Medical Dr
Palestine, TX 75801
Phone (903) 729-3100

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1801454020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MEDICAL DR",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758014781",
            "telephone_number": "903-729-3100",
            "fax_number": "903-729-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MEDICAL DR",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758014781",
            "telephone_number": "903-729-3100",
            "fax_number": "903-729-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNOY",
        "first_name": "GEORGE",
        "middle_name": "LAYNE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-03",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "26160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palestine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.