NPIMap

Organization Active NPI

Buena Vista Pharmacy Inc

  • Community/Retail Pharmacy
  • Pipe Creek, TX
National Provider Identifier
1851738066
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
10582 Issued in TX
Legal business name
BUENA VISTA PHARMACY INC
Doing business as
SUPER DRUG MART TELEPHARMACY
Practice address
146 Laurel Vista Dr
Pipe Creek, TX 78063-6389
Phone
(830) 751-2700
Fax
(830) 751-2724
NPI assigned
May 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2013

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

Authorized official

Name
Raymond Ibanez
Title
Pharmacist in Charge/Owner
Phone
(210) 674-1900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 10582 TX Primary

Addresses

Primary practice location

146 Laurel Vista Dr
Pipe Creek, TX 78063-6389

Mailing address

7323 Marbach Rd Ste 105
San Antonio, TX 78227-1905
Phone (210) 674-1900

Other identifiers 2

IdentifierTypeStateIssuer
2140489OtherPK
016578901MedicaidTX

Other names 1

  • SUPER DRUG MART TELEPHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Buena Vista Pharmacy Inc2 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.

NPI Registry JSON

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369785600000",
    "number": "1851738066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7323 MARBACH RD STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782271905",
            "telephone_number": "210-674-1900",
            "fax_number": "210-674-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 LAUREL VISTA DR",
            "city": "PIPE CREEK",
            "state": "TX",
            "postal_code": "780636389",
            "telephone_number": "830-751-2700",
            "fax_number": "830-751-2724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUENA VISTA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-29",
        "last_updated": "2013-05-29",
        "status": "A",
        "authorized_official_last_name": "IBANEZ",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE/OWNER",
        "authorized_official_telephone_number": "210-674-1900"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "10582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2140489",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016578901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUPER DRUG MART TELEPHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pipe Creek, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.