Cip Northside LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

31261 Issued in TX

Legal business name

CIP NORTHSIDE LLC

Doing business as

Taylor County Pharmacy

Practice address

1640 State Highway 351
Abilene, TX 79601-4746

Phone

(325) 704-4208

Fax

(325) 305-0565

NPI assigned

Jan 17, 2017

Last updated

Apr 24, 2020By 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

Cody Clark, PHARMDNPI 1972271260

Title

Managing Officer/Owner/Ao

Phone

(806) 773-5958

Specialties & licenses 2

Addresses

Other names 1

• Taylor County Pharmacy Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cody Clark, PHARMD

  • Pharmacist
  • Spring Hill, TN
  • NPI 1972271260
  NPD Authorized official
• Amy Elizabeth Watts, PHARM.D.

  • Pharmacist
  • Abilene, TX
  • NPI 1801364104
  NPD (past)

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": [],
    "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"
        }
    ]
}

• Christian Chaney Business
• Cassie Christian, LCSW
• Caitlin Elizabeth Christiansen, PA-C
• Christopher S. Eddleman, M.D., PHD, PLLC
• Bogdan A Chumak, MD
• Cip Northside LLC (CIP Northside Pharmacy)
• City of Abilene (Abilene-Taylor County Public Health District)
• CL Haven Enterprises
• Aaron Jonathan Clark, PA
• Charles Leroy Clark III, M.D.

• Community/Retail Pharmacy in Abilene, TX
• Providers in Abilene, 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 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.