TD Healthcare LLC
Organization Active NPI Community/Retail Pharmacy · Denver City, TX
NPI 1821379587 · NPPES record last updated Aug 3, 2017
Key facts
- NPI
- 1821379587
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 27633 (TX)
- Legal business name
- TD HEALTHCARE LLC
- Practice address
- 105 E Broadway St
Denver City, TX 79323-3225 - Phone
- (806) 592-3333
- Fax
- (806) 592-3633
- NPI assigned
- Sep 7, 2011
- Organization subpart
- No
Authorized official
- Name
- David Fung, RPH
- Title
- Owner/Managing Officer
- Phone
- (813) 244-9882
Practitioners 3
-
David L Fung, RPH
-
Nicole M Mahabir-Herrera, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210111001572 | TX | Part B Supplier - Mass Immunization (Roster Biller Only) | 8628389293 | Practice locations: Denver City, TX |
National Provider Directory
Locations
105 E Broadway St
Denver City, TX 79323
Phone (806) 592-3333
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 27633 | TX | Yes |
| Compounding Pharmacy | 3336C0004X | |||
| Specialty Pharmacy | 3336S0011X |
Addresses
Primary practice location
105 E Broadway St
Denver City, TX 79323-3225
Mailing address
105 E Broadway St
Denver City, TX 79323-3225
Phone (806) 592-3333
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2131862 | Other | PK | |
| 148297 | Medicaid | TX |
Other names
- Denver City Pharmacy
Other providers in Denver City, TX
- Shannon Parker
- Julia Kathleen Pirtle
- Sarala Kumari Sajja
- South Plains Public Health District
- South Plains Renal Associates
- Tiffany D Murrish
- Frank Villanueva
- Marlin Villegas
- Yoakum County Hospital
- Yoakum County Medical Associates PLLC
All providers in Denver City, TX · Community/Retail Pharmacy in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.