Specialty Therapeutic Care LP

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SPECIALTY THERAPEUTIC CARE LP

Practice address

1311 W Sam Houston Pkwy N Ste 150
Houston, TX 77043

Phone

(866) 506-2626

Fax

(866) 834-8523

NPI assigned

Jun 8, 2005

Organization subpart

No

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

Authorized official

Name

Jessica Dawn Ciccolella-Kahl

Title

President

Phone

(800) 511-5144

Specialties & licenses 4

Addresses

Other identifiers 18

Locations

Practitioners 2

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

• Vanessa Michelle Bates, PHARMD

  • Pharmacist
  • Dallas, TX
  • NPI 1740609163
  NPD (past)
• Shubha Vaidya

  • Pharmacist
  • Houston, TX
  • NPI 1518456714
  NPD (past)

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707436800000",
    "number": "1962406850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 956780",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631956780",
            "telephone_number": "855-422-2742",
            "fax_number": "866-834-8523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 W SAM HOUSTON PKWY N STE 150",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77043",
            "telephone_number": "866-506-2626",
            "fax_number": "866-834-8523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY THERAPEUTIC CARE LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-08",
        "last_updated": "2024-02-09",
        "certification_date": "2023-08-16",
        "status": "A",
        "authorized_official_last_name": "CICCOLELLA-KAHL",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-511-5144"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
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            "identifier": "1578774",
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        },
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            "issuer": null,
            "identifier": "1962406850",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962406850",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962406850",
            "state": "TN"
        },
        {
            "code": "05",
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            "issuer": null,
            "identifier": "200096950A",
            "state": "OK"
        },
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            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "73169880001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2097210",
            "state": null
        },
        {
            "code": "05",
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            "issuer": null,
            "identifier": "7T4102",
            "state": "SC"
        },
        {
            "code": "05",
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            "identifier": "0160873",
            "state": "OH"
        },
        {
            "code": "05",
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            "issuer": null,
            "identifier": "131430006",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148018",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100232400",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WY0122",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003136712A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10100264788-00",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192697407",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3094450",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6029680",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Houston, TX
• Providers in Houston, 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 Feb 9, 2024; 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.