Medfusion Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

MEDFUSION PHARMACY

Practice address

8812 Broadway St Ste a
San Antonio, TX 78217-6318

Phone

(210) 624-7648

Fax

(888) 217-1216

NPI assigned

Sep 25, 2018

Organization subpart

Yes

Parent organization

MEDFUSION, LLCAs reported in NPPES

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

Authorized official

Name

Thomas Gray Hardaway

Title

Owner

Phone

(210) 445-9079

Specialties & licenses 1

Addresses

Part of

Medfusion Pharmacy

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matt Tullis, R.PH.

  • Pharmacist
  • San Antonio, TX
  • NPI 1841754314
  NPD (past)

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537833600000",
    "number": "1891279915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17115 SAN PEDRO AVE STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782322685",
            "telephone_number": "210-445-9079",
            "fax_number": "888-217-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8812 BROADWAY ST STE A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782176318",
            "telephone_number": "210-624-7648",
            "fax_number": "888-217-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFUSION PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDFUSION, LLC",
        "enumeration_date": "2018-09-25",
        "last_updated": "2018-09-25",
        "status": "A",
        "authorized_official_last_name": "HARDAWAY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "GRAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-445-9079"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle V Medellin, M.D.
• Raquel R Medellin
• Medex Home Health (Same As Above)
• Medexpress Primary Care Texas, P.a. (The Well - San Antonio)
• Medfund LLC (Horizon MRI of San Antonio North LLC)
• Medi-Ryde, LLC (MediRyde)
• Medi-Tronics
• Medicaid360, Inc.
• Medical and Health Physicians of San Antonio PLLC
• Medical Care Innovation, P.C.

• Pharmacy in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.