TARA PHARMACY , NPI 1821292731 — PEARL (MS)

NPI 1821292731

12+ Years Experience Organization

TARA PHARMACY

06/13/2007
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1821292731
NPI NUMBER

About TARA PHARMACY

TARA PHARMACY is a provider established in PEARL, MS. The NPI number of TARA PHARMACY is 1821292731 and was assigned on 06/13/2007. The practitioners primary taxonomy code is: 3336L0003X .

Mailing address

  • City: ORCHARD PARK
  • State: NY
  • Postal code: 141270428
  • Phone: 7166624955
  • Address: PO BOX 428
  • Address 2: 3690 SOUTHWESTERN BLVD

Primary Practice Address

  • Region : PEARL, MS
  • NPI : 1821292731
  • Phone : 6017508059
  • Postalcode : 39218
  • Address : 110 METROPLEX BLVD SUITE H

Provider taxonomy - Pharmacy

  • Taxonomy code: 3336L0003X

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: 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.

Contacts:

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  • TARA PHARMACY
  • Address : 110 METROPLEX BLVD SUITE H
  • Region : PEARL, MS
  • NPI : 1821292731
  • Phone : 6017508059
  • Postalcode : 39218

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 2059160226
  • Title or position : VP OF PHARMACY OPERATIONS

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address110 METROPLEX BLVD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE H
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NamePEARL
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameMS
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code39218
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number6017508059
The telephone number associated with the location address of the provider being identified.
NPI1821292731
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 13336L0003X
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.
Provider Enumeration Date06/13/2007
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)TARA PHARMACY
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing AddressPO BOX 428
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing Address3690 SOUTHWESTERN BLVD
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameORCHARD PARK
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameNY
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code141270428
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number7166624955
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Authorized Official Last NameDUNN
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameROBERT
The first name of the authorized official
Authorized Official Title or PositionVP OF PHARMACY OPERATIONS
The title or position of the authorized official
Authorized Official Name Prefix TextMR.
Authorized Official Name Prefix Text
Authorized Official Telephone Number2059160226
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #13336L0003X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Pharmacy
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.
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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