DOUGHERTYS LTC PHARMACY LLC (NPI# 1578093183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578093183 |
| Entity Type | Organization |
| Organization Name | DOUGHERTYS LTC PHARMACY LLC |
| Other Organization Name | DOUGHERTY'S LTC PHARMACY |
| Practice Address |
5959 Royal Ln Ste 513 Dallas TX 75230-3856 |
| Mailing Address |
5959 Royal Ln Suite 513 Dallas TX 75230-3856 |
| Practice Telephone | 2143735301 |
| Practice Fax Number | 2143735333 |
| Mailing Telephone | 2143735301 |
| Mailing Fax Number | 2143735333 |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2018-07-19 |
| Authorized Official Name | ANDREW KOMUVES (PRESIDENT&CEO) |
| Authorized Official Telephone | 9728600229 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
31452 | TX | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 351064 | 05 | |
| PK | 2169947 | 01 |
| Other Name | Type Code |
|---|---|
| DOUGHERTY'S LTC PHARMACY | Doing Business As Name - Organization |
| Street Address |
5959 ROYAL LN STE 513 |
| City | DALLAS |
| State | TX |
| Zip Code | 75230-3856 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912552415 | Kyoto Medical Services, Pllc | Orthopaedic Surgery | 12890 Hillcrest Plaza Drive, Suite K111, Dallas, TX 75230 | 2019-08-02 |
| 1528538170 | Angel Laamber Adams | Nurse Practitioner | 7777 Forest Lane Suite C 833, Dallas, TX 75230 | 2018-11-27 |
| 1538634399 | Tochukwu Chioma Uche-ukah | Nurse Practitioner | Dr Katari, Encompass Health Rehabilitations, 7930 Northaven Rd, Dallas, TX 75230 | 2018-10-09 |
| 1790260958 | Ability Aba, Pllc | Behavioral Analyst | 5930 Royal Lane Ste E, #301, Dallas, TX 75230 | 2018-10-03 |
| 1750887956 | Brandi Nicole Freeman | Behavioral Analyst | 5639 Mcshann Rd, Dallas, TX 75230 | 2018-04-05 |
| 1326547720 | Whitney A Stewart | Psychologist | 5924 Royal Lane, Ste 258, Preston Hollow Health & Wellness, Dallas, TX 75230 | 2018-02-12 |
| 1407384373 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7859 Walnut Hill Ln Ste 110, Dallas, TX 75230 | 2017-05-23 |
| 1215488648 | The Walker Wellness Clinic | Community/Behavioral Health | 12200 Preston Rd., Dallas, TX 75230 | 2016-10-20 |
| 1578912325 | Renat Kudyakov | Nurse Practitioner | 7777 Forest Ln Ste B-446, Dallas, TX 75230 | 2016-06-11 |
| 1407210982 | Rohan Venugopal Menon | Pediatrics | 7777 Forest Lane, Bldg B 300, Dallas, TX 75230 | 2016-04-11 |
| Find all providers in zip 75230 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366928780 | Jc Millennium Enterprises, LLC | Pharmacy | 4926 Columbia Ave, Dallas, TX 75214-5506 | 2018-07-18 |
| 1972016541 | Onesource Specialty Medicine LLC | Pharmacy | 8989 Forest Ln Ste 138, Dallas, TX 75243-4137 | 2017-11-06 |
| 1427370766 | Pride Pharmacy - Carlisle LLC | Pharmacy | 4015 Lemmon Ave Ste 4001, Dallas, TX 75219-3737 | 2010-02-26 |
| 1609179712 | Genoa Healthcare, LLC | Pharmacy | 2600 N Stemmons Fwy, Dallas, TX 75207-2113 | 2010-12-10 |
| 1982920419 | Five Star Pharmacy Services LLC | Pharmacy | 14800 Landmark Blvd, Suite 250, Dallas, TX 75254-7565 | 2010-04-08 |
| 1306168786 | Genoa Healthcare, LLC | Pharmacy | 9708 Skillman St, Dallas, TX 75243-5150 | 2010-02-25 |
| 1235374877 | Kasprzyk Enterprises Inc | Pharmacy | 289 E Ellendale Ave, Suite 402, Dallas, OR 97338-1580 | 2008-12-11 |
| 1184711095 | Partners Pharmacy of Texas, LLC | Pharmacy | 8600 Skyline Dr, Dallas, TX 75243-4198 | 2006-10-10 |
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| 1962029959 | Texas Rxsolutions and Compounding Pharmacy | Pharmacy | 7505 Fannin Street., Suite 140, Houston, TX 77054-1974 | 2020-06-25 |
| 1336764877 | Precise Drugs Tx Inc | Pharmacy | 1510 Randolph St Ste 503, Carrollton, TX 75006-7476 | 2020-06-10 |
| 1871114421 | Alamo Health LLC | Pharmacy | 408 Us Highway 90 W Ste B, Castroville, TX 78009-4548 | 2020-05-05 |
| 1962022442 | Hewitt Drug | Pharmacy | 511 N Hewitt Dr Ste 1, Hewitt, TX 76643-3093 | 2020-04-24 |
| 1285254060 | River Road Pharmacy | Pharmacy | 910 River Rd, Boerne, TX 78006-2441 | 2020-04-21 |
| 1750900015 | Thousand Oaks Healthcare LLC | Pharmacy | 426 Castroville Rd Ste 5, San Antonio, TX 78207-5169 | 2020-04-15 |
| 1639708464 | Thirumala Group LLC | Pharmacy | 100 W Princeton Dr Ste A, Princeton, TX 75407-9607 | 2020-04-03 |
| 1982230488 | Rio Grande Pharmacy, LLC | Pharmacy | 5500 Doniphan Dr Ste 201-202, El Paso, TX 79932-1454 | 2020-03-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.