Clarksville Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CLARKSVILLE PHARMACY LLC

Doing business as

Clarksville Pharmacy

Practice address

1312 W Main St
Clarksville, TX 75426-3525

Phone

(903) 706-5065

NPI assigned

Apr 16, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Machender Reddy Kandadi, PHDNPI 1376916577

Title

Officer

Phone

(307) 399-3786

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Clarksville Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

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

• Machender Reddy Kandadi, RPH., PHD

  • Pharmacist
  • Paris, TX
  • NPI 1376916577
  NPD Authorized official
• Rachana Balusu

  • Pharmacist
  • Clarksville, TX
  • NPI 1124839667
  NPD (past)
• Rajkumar Maria Susai

  • Pharmacist
  • Clarksville, TX
  • NPI 1902468325
  NPD (past)

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555372800000",
    "number": "1891358818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 LAMAR AVE STE B",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754605024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 W MAIN ST",
            "city": "CLARKSVILLE",
            "state": "TX",
            "postal_code": "754263525",
            "telephone_number": "903-706-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSVILLE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-04-16",
        "status": "A",
        "authorized_official_last_name": "KANDADI",
        "authorized_official_first_name": "MACHENDER",
        "authorized_official_middle_name": "REDDY",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "307-399-3786",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF PHARMACY",
            "identifier": "32594",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarksville Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Luther Bryson, PH
• Chambers County Public Hospital District No. 1 (Focused Care at Clarksville)
• Charles Michael Taylor II
• Clarksville I.S.D.
• Clarksville Nursing Center, L.P. (Clarksville Nursing Center)
• Bobby S. Conway, M.S. LPC
• Core Health Systems
• Country Home Care, Inc. (Country Home Care)
• CVS Pharmacy Inc (CVS Pharmacy # 11152)
• Daily Medical Supply, Inc. (Home Oxygen & Medical Equipment)

• Community/Retail Pharmacy in Clarksville, TX
• Providers in Clarksville, 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 Apr 16, 2019; 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.