Clarendon Outpost

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

16767 Issued in TX

Legal business name

CLARENDON OUTPOST

Practice address

619 W 2ND St
Clarendon, TX 79226

Phone

(806) 874-5202

Fax

(806) 874-5204

NPI assigned

Sep 8, 2017

Organization subpart

No

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

Authorized official

Name

Elmonette E Bivens

Title

Pharmacist in Charge

Phone

(806) 874-5202

Specialties & licenses 3

Addresses

Other identifiers 4

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1982122115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 927",
            "city": "CLARENDON",
            "state": "TX",
            "postal_code": "792260927",
            "telephone_number": "806-874-5202",
            "fax_number": "806-874-5204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 W 2ND ST",
            "city": "CLARENDON",
            "state": "TX",
            "postal_code": "79226",
            "telephone_number": "806-874-5202",
            "fax_number": "806-874-5204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARENDON OUTPOST",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-08",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "BIVENS",
        "authorized_official_first_name": "ELMONETTE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "806-874-5202"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "TX",
            "license": "16767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144483",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010761701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104530001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014359601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clarendon Dental Associates PLLC
• Clarendon Family Medicine PLLC
• Clarendon Family Medicine PLLC
• Clarendon NH Operations
• Clarendon Outpost
• Clarendon Skilled Care LTD
• Donley County Hospital District
• Donley County Medical Group PA
• Donley County RHC Corporation
• Brandon David Frausto, PHARM.D.

• Long Term Care Pharmacy in Clarendon, TX
• Providers in Clarendon, 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 Jun 16, 2021; 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.