Organization Active NPI

Paloma'S Pharmacy,LLC

  • Community/Retail Pharmacy
  • Mission, TX
National Provider Identifier
1871882886
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
27433 Issued in TX
Legal business name
PALOMA'S PHARMACY,LLC
Doing business as
Apple Pharmacy #3
Practice address
909 Business Park Dr Ste 2
Mission, TX 78572-6054
Phone
(956) 424-6268
Fax
(956) 424-6258
NPI assigned
Mar 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Authorized official

Name
Mr. Jose A Vela, PHARM.D, R.PH.
Title
Corp-President
Phone
(956) 821-2886

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 27433 TX Primary

Addresses

Primary practice location

909 Business Park Dr Ste 2
Mission, TX 78572-6054

Mailing address

909 Business Park Dr
Mission, TX 78572-6052
Phone (956) 424-6268

Other identifiers 1

IdentifierTypeStateIssuer
146386MedicaidTX

Other names 1

  • Apple Pharmacy #3 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111227000558 TX Part B Supplier - Pharmacy 3870769706 Practice locations: Mission, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1301443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589241600000",
    "number": "1871882886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 BUSINESS PARK DR",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785726052",
            "telephone_number": "956-424-6268",
            "fax_number": "956-424-6258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 BUSINESS PARK DR STE 2",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785726054",
            "telephone_number": "956-424-6268",
            "fax_number": "956-424-6258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALOMA'S PHARMACY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-30",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A",
        "authorized_official_last_name": "VELA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CORP-PRESIDENT",
        "authorized_official_telephone_number": "956-821-2886",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARM.D, R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "27433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146386",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Apple Pharmacy #3",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mission, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.