Lifecare Pharmacy Culebra LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

31362 Issued in TX

Legal business name

LIFECARE PHARMACY CULEBRA LLC

Doing business as

Lifecare Pharmacy Culebra

Practice address

7614 Culebra Rd Ste 101
San Antonio, TX 78251-1477

Phone

(210) 769-8014

Fax

(210) 569-6464

NPI assigned

Apr 26, 2017

Last updated

Jul 27, 2018By 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

Prem KalidindiNPI 1699102699

Title

Managing Partner

Phone

(917) 769-8014

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Lifecare Pharmacy Culebra Doing business as

Locations

Practitioners 1

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.

• Prem S. Kalidindi

  • Pharmacist
  • Irving, TX
  • NPI 1699102699
  Authorized official Same address or phone

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532649600000",
    "number": "1891220075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12929",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78212",
            "telephone_number": "210-881-0890",
            "fax_number": "210-569-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7614 CULEBRA RD STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782511477",
            "telephone_number": "210-769-8014",
            "fax_number": "210-569-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECARE PHARMACY CULEBRA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-26",
        "last_updated": "2018-07-27",
        "status": "A",
        "authorized_official_last_name": "KALIDINDI",
        "authorized_official_first_name": "PREM",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "917-769-8014"
    },
    "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": "31362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149670",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2168983",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifecare Pharmacy Culebra",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in San Antonio, TX
• Providers in San Antonio, 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 Jul 27, 2018; 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.