NPIMap

Organization Active NPI

Medicine Store Pharmacy

  • Pharmacist
  • Fort Worth, TX
National Provider Identifier
1851385595
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20447 Issued in TX
Legal business name
MEDICINE STORE PHARMACY
Practice address
1400 S Main St
Suite 101
Fort Worth, TX 76104-4909
Phone
(817) 338-0628
NPI assigned
Sep 8, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Frances Garcia
Title
Office-MGR
Phone
(817) 877-4347

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 20447 TX Primary

Addresses

Primary practice location

1400 S Main St
Suite 101
Fort Worth, TX 76104-4909

Mailing address

1400 S Main St
Suite 101
Fort Worth, TX 76104-4909

Other identifiers 1

IdentifierTypeStateIssuer
144674MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Medicine Store Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1400 S Main St
Ste 101
Fort Worth, TX 76104
Phone (817) 338-0628

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851385595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S MAIN ST",
            "address_2": "SUITE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S MAIN ST",
            "address_2": "SUITE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044909",
            "telephone_number": "817-338-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINE STORE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "FRANCES",
        "authorized_official_title_or_position": "OFFICE-MGR",
        "authorized_official_telephone_number": "817-877-4347"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "20447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144674",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.