NPIMap

Organization Active NPI

Cip Northside LLC

  • Community/Retail Pharmacy
  • Abilene, TX
National Provider Identifier
1831635697
Registry record updated Apr 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
31261 Issued in TX
Legal business name
CIP NORTHSIDE LLC
Practice address
1640 State Highway 351
Abilene, TX 79601-4746
Phone
(325) 704-4208
Fax
(325) 305-0565
NPI assigned
Jan 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2020

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

Authorized official

Name
Cody Clark, PHARMDNPI 1972271260
Title
Managing Officer/Owner/Ao
Phone
(806) 773-5958

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 31261 TX Primary

Addresses

Primary practice location

1640 State Highway 351
Abilene, TX 79601-4746

Mailing address

3410 98TH St Ste 4-369
Lubbock, TX 79423-3847
Phone (806) 451-4799

Other identifiers 1

IdentifierTypeStateIssuer
2167749OtherPK

Other names 1

  • Taylor County Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

4400 Buffalo Gap Rd
Ste 400
Abilene, TX 79606

1640 State Highway 351
Abilene, TX 79601
Phone (325) 704-4207

3410 98th St
Ste 4369
Lubbock, TX 79423

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587686400000",
    "number": "1831635697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 98TH ST STE 4-369",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794233847",
            "telephone_number": "806-451-4799",
            "fax_number": "325-305-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 STATE HIGHWAY 351",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796014746",
            "telephone_number": "325-704-4208",
            "fax_number": "325-305-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIP NORTHSIDE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-17",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "MANAGING OFFICER/OWNER/AO",
        "authorized_official_telephone_number": "806-773-5958",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "31261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167749",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Taylor County Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Taylor County Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2020; 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.