Rodney A Demoss, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

10210 Issued in TX

Practice address

507 23Rd St
Canyon, TX 79015-4043

Phone

(806) 655-1024

Fax

(806) 655-9762

NPI assigned

Oct 17, 2005

Sex

Male

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Medi-Drive Pharmacy LLC

  • Pharmacy
  • Canyon, TX
  • NPI 1962687251
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 9, 2008.

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1922097518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 23RD ST",
            "city": "CANYON",
            "state": "TX",
            "postal_code": "790154043",
            "telephone_number": "806-655-1024",
            "fax_number": "806-655-9762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 23RD ST",
            "city": "CANYON",
            "state": "TX",
            "postal_code": "790154043",
            "telephone_number": "806-655-1024",
            "fax_number": "806-655-9762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMOSS",
        "first_name": "RODNEY",
        "middle_name": "A",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "10210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142463",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4564731",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth A. Crossland, D.D.S.
• Maureen Cuevas, LCSW, PHD
• Leslie W Dalton Jr.
• Deellen Marie Davis
• Stephanie Ann Dawdy, LPC, LSSP
• Brandy Nichole Dempsey, FNP
• Mandy Jo Dobrowolski, FNP
• Lee A Doernte, PHD
• Rory Don Douglas, RN
• Tracey Dianne Ecklund

• All providers in Canyon, TX
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.