DERAMED SPECIALTY PHARMACY (NPI# 1801414933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801414933 |
| Entity Type | Organization |
| Organization Name | DERAMED SPECIALTY PHARMACY |
| Practice Address |
1001 Matlock Rd Ste 105 Mansfield TX 76063-3443 |
| Practice Telephone | 8175923636 |
| Mailing Telephone | 8175923636 |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2020-07-06 |
| Authorized Official Name | ADERONKE EFUNOGBON (DIRECTOR) |
| Authorized Official Telephone | 8175923636 |
| Is Organization Subpart | Y |
| Parent Organization Name | DERHANN CO. LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| DeraMed Specialty Pharmacy | Doing Business As Name - Organization |
| Street Address |
1001 MATLOCK RD STE 105 |
| City | MANSFIELD |
| State | TX |
| Zip Code | 76063-3443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407248875 | Aderonke Efunogbon | Pharmacist | 1001 Matlock Rd Ste 105, Mansfield, TX 76063 | 2015-02-23 |
| 1164997169 | Derhann Co. LLC | Pharmacy | 1001 Matlock Rd Ste 105, Mansfield, TX 76063-3443 | 2018-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316558349 | Lindsey Vandyke, D.o. Pllc | Internal Medicine | 3150 E Broad Street, Ste 100, Mansfield, TX 76063 | 2020-08-13 |
| 1942819867 | Jennifer Que Chau Nguyen | Pharmacist | 980 U.S. 287 Frontage Rd #287, Mansfield, TX 76063 | 2020-07-27 |
| 1194346890 | Ana Maria Gonzalez | Dentist | 1600 Us Highway 287, Suite 102, Mansfield, TX 76063 | 2020-05-04 |
| 1245869080 | Stateserv Medical of Texas, LLC | Durable Medical Equipment & Medical Supplies | 7941 Rodeo Trail, Mansfield, TX 76063 | 2020-04-03 |
| 1649802232 | Mary Puanani Kamai | Nurse Practitioner | 1301 E. Debbie Lane, Suite 102 #1405, Mansfield, TX 76063 | 2020-02-11 |
| 1770123028 | Gladys Vera Nfodzo | Nurse Practitioner | 901 W. Broad St, Mansfield, TX 76063 | 2020-01-14 |
| 1669011300 | Alexa Smith | Nurse Practitioner | 2800 E Broad St #304, Mansfield, TX 76063 | 2019-12-28 |
| 1477190437 | Mel Rockwall LLC | Optometrist | 1701 East Broad Street, Ste 109, Mansfield, TX 76063 | 2019-12-09 |
| 1376185512 | Daniel Max & Marcandrea LLC | Optometrist | 1701 East Broad St., Ste 109, Mansfield, TX 76063 | 2019-10-09 |
| 1861046385 | Lacey Eaton | Counselor | 805 Killian Dr, Mansfield, TX 76063 | 2019-08-01 |
| Find all providers in zip 76063 | ||||
| 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 |
|---|---|---|---|---|
| 1306268297 | Valentine Long Term Care LLC | Pharmacy | 407 Polk St, Mansfield, LA 71052-2405 | 2014-01-10 |
| 1215034053 | Mansfield Drug Inc | Pharmacy | 132 Jefferson St, Mansfield, LA 71052-2602 | 2006-09-20 |
| 1578677555 | Valentine Pharmacy Inc | Pharmacy | 116 Jefferson St, Mansfield, LA 71052-2602 | 2006-08-18 |
| 1164997169 | Derhann Co. LLC | Pharmacy | 1001 Matlock Rd Ste 105, Mansfield, TX 76063-3443 | 2018-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760082481 | San Marcos Treatment Facility | Pharmacy | 120 Bert Brown Rd, San Marcos, TX 78666-5803 | 2020-10-30 |
| 1114524212 | Yousenasna Group LLC | Pharmacy | 506 Graham Dr Ste 140, Tomball, TX 77375-3346 | 2020-10-02 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.