West Old Corner Drug, Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

6826 Issued in TX

Legal business name

WEST OLD CORNER DRUG, INC

Doing business as

OLD CORNER DRUG

Practice address

200 N Main St
West, TX 76691-1207

Phone

(254) 826-5122

Fax

(254) 826-3768

NPI assigned

Sep 13, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Randy James Niemeyer, PHARMD

Title

Owner/Pharmacist

Phone

(254) 826-5122

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• OLD CORNER DRUG Doing business as

Practitioners 1

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

• Avery Kirk Wines, R PH

  • Pharmacist
  • West, TX
  • NPI 1891727004
  NPD

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1962921700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N MAIN ST",
            "city": "WEST",
            "state": "TX",
            "postal_code": "766911207",
            "telephone_number": "254-826-5122",
            "fax_number": "254-826-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N MAIN ST",
            "city": "WEST",
            "state": "TX",
            "postal_code": "766911207",
            "telephone_number": "254-826-5122",
            "fax_number": "254-826-3768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST OLD CORNER DRUG, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-13",
        "last_updated": "2022-07-21",
        "certification_date": "2021-03-03",
        "status": "A",
        "authorized_official_last_name": "NIEMEYER",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "254-826-5122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "TX",
            "license": "6826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142315",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OLD CORNER DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• West Hospital Authority
• West Isd
• West Medical and Surgical Clinic Association
• West Oak Medical Clinic PA
• West Old Corner Drug, Inc
• West Station Enterprise Inc
• West Voluntary Ambulance Association
• Jessica Leigh Wilkinson, PTA
• Jennifer Michele Wilson, LVN
• Sharon Wilson, LO

• Long Term Care Pharmacy in West, TX
• Providers in West, TX by specialty
• Long Term Care Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.