Organization Active NPI

Nova Health LLC

  • Community/Retail Pharmacy
  • Plano, TX
National Provider Identifier
1952933038
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
NOVA HEALTH LLC
Practice address
1408 Summit Ave Ste 2
Plano, TX 75074-8135
Phone
(972) 726-9009
Fax
(469) 661-3905
NPI assigned
Feb 6, 2020
Last updated
Jul 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Authorized official

Name
Dr. Neveen Nofal, REGISTEREDPHARMACISTNPI 1205468386
Title
Pic
Phone
(865) 765-1771

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1408 Summit Ave Ste 2
Plano, TX 75074-8135

Mailing address

1408 Summit Ave Ste 2
Plano, TX 75074-8135
Phone (972) 729-9009

Other identifiers 1

IdentifierTypeStateIssuer
150194MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL micromerchantsystem.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220216000930 TX Part B Supplier - Pharmacy 4789077785 Practice locations: Plano, TX

National Provider Directory

National Provider Directory

Locations

1408 Summit Ave
Ste 2
Plano, TX 75074
Phone (865) 765-1771

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.

NPI Registry JSON

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594339200000",
    "number": "1952933038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 SUMMIT AVE STE 2",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750748135",
            "telephone_number": "972-729-9009",
            "fax_number": "469-661-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 SUMMIT AVE STE 2",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750748135",
            "telephone_number": "972-726-9009",
            "fax_number": "469-661-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-06",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A",
        "authorized_official_last_name": "NOFAL",
        "authorized_official_first_name": "NEVEEN",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "865-765-1771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "REGISTEREDPHARMACIST"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150194",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "micromerchantsystem.com",
            "affiliation": "N",
            "address_1": "1408 Summit Ave Ste 2",
            "city": "Plano",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750748135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; 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.