Active NPI
Medfront LLC
Doing business as MedFont Pharmacy
- Community/Retail Pharmacy
- Dallas, TX
National Provider Identifier
1932478112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 27977
- Legal business name
- MEDFRONT LLC
- Doing business as
- MedFont Pharmacy
- Practice address
- 4041 W Wheatland Rd Ste 204
Dallas, TX 75237-4061 - Phone
- (972) 709-2190
- Fax
- (972) 709-0190
- NPI assigned
- Dec 18, 2011
- Last updated
- Jul 19, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Olamide Makinde, PHARM.D
- Title
- Owner/MGR/Pic
- Phone
- (972) 709-2190
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 27977 | TX | Primary |
| Compounding Pharmacy | 3336C0004X | |||
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
4041 W Wheatland Rd Ste 204
Dallas, TX 75237-4061
Mailing address
4041 W Wheatland Rd
Suite 204
Dallas, TX 75237-4063
Phone (972) 709-2190
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 340061603 | Medicaid | TX | |
| 2135058 | Other | PK | |
| 340061602 | Medicaid | TX | |
| 340061601 | Medicaid | TX |
Other names 1
- MedFont Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140618001901 | TX | DME Supplier - Pharmacy | 5496979114 | Practice locations: Dallas, TX |
| O20151028002386 | TX | Part B Supplier - Mass Immunization (Roster Biller Only) | 5496979114 | Practice locations: Dallas, TX |
National Provider Directory
National Provider Directory- Tax ID family
- Medfront LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
Practitioners & affiliated clinicians
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.
-
- Pharmacist
- Dallas, TX
- NPI 1992033286
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324166400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1531958400000",
"number": "1932478112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4041 W WHEATLAND RD",
"address_2": "SUITE 204",
"city": "DALLAS",
"state": "TX",
"postal_code": "752374063",
"telephone_number": "972-709-2190",
"fax_number": "972-709-0190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4041 W WHEATLAND RD STE 204",
"city": "DALLAS",
"state": "TX",
"postal_code": "752374061",
"telephone_number": "972-709-2190",
"fax_number": "972-709-0190"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDFRONT LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-12-18",
"last_updated": "2018-07-19",
"status": "A",
"authorized_official_last_name": "MAKINDE",
"authorized_official_first_name": "OLAMIDE",
"authorized_official_title_or_position": "OWNER/MGR/PIC",
"authorized_official_telephone_number": "972-709-2190",
"authorized_official_credential": "PHARM.D"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "TX",
"license": "27977",
"primary": true
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "340061603",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2135058",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "340061602",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "340061601",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MedFont Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Dallas, TX
- Jane Medema
- Vivek Medepalli, MD
- Medexpress Urgent Care Texas, P.a. (MedExpress Urgent Care - Dallas, Lake June Rd)
- Medford McCoy MD PA (Pathology Consultants of Dallas)
- Richard Medford, MD
- Medfront LLC (MedFront Long Term Care Pharmacy)
- Medfund LLC (Horizon MRI of Duncanville LLC)
- Medgenix Healthcare LLC
- Medhealers Housecall Physicians LLC
- Medhealth (Methodist Brain and Spine Institute)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.