FREDERICKSBURG LTC (NPI# 1174767362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174767362 |
| Entity Type | Organization |
| Organization Name | FREDERICKSBURG LTC |
| Other Organization Name | FREDERICKSBURG LTC |
| Practice Address |
707 N Llano St Suite B Fredericksburg TX 78624-3943 |
| Practice Telephone | 8309975800 |
| Practice Fax Number | 8309970068 |
| Mailing Telephone | 8309975800 |
| Mailing Fax Number | 8309970068 |
| Enumeration Date | 2009-05-01 |
| Last Update Date | 2017-03-01 |
| Authorized Official Name | WHITNEY ROBERTS (OWNER) |
| Authorized Official Telephone | 8309975800 |
| 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 |
26428 | TX | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 350224 | 05 | |
| PK | 2120084 | 01 |
| Other Name | Type Code |
|---|---|
| Fredericksburg LTC | Doing Business As Name - Organization |
| Street Address |
707 N LLANO ST SUITE B |
| City | FREDERICKSBURG |
| State | TX |
| Zip Code | 78624-3943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174684732 | Valu-med Inc. | Pharmacy | 707 N Llano St, Fredericksburg, TX 78624-3943 | 2006-12-13 |
| 1700156908 | Christy W Pounds | Pharmacist | 707 N Llano St, Fredericksburg, TX 78624-3943 | 2012-01-04 |
| 1730458209 | William Michael Roberts | Pharmacist | 707 N Llano St, Fredericksburg, TX 78624-3943 | 2011-12-29 |
| 1457620932 | Bill Edward Borron | Pharmacist | 707 N Llano St, Fredericksburg, TX 78624-3943 | 2011-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992357669 | Cynthia Hui Kim | Registered Nurse | 1020 S State, Tx-16, Fredericksburg, TX 78624 | 2019-07-12 |
| 1023515533 | Fredericksburg Eye Associates, Pllc | Ophthalmology | 755 S. Washington St., Fredericksburg, TX 78624 | 2018-04-11 |
| 1922503358 | Ave Maria Hospice of Fredericksburg, LLC | Hospice Care, Community Based | 204 S. Adams St. #a, Fredericksburg, TX 78624 | 2018-03-27 |
| 1225568546 | David Ronald Rickerhauser | Counselor | 400 Prairie View Trail, Fredericksurg, TX 78624 | 2017-06-19 |
| 1144629734 | Amy Taylor | Nurse Practitioner | 1020 Hwy 16, Fredericksburg, TX 78624 | 2014-08-19 |
| 1578836532 | James W. Harrington Jr. | Otolaryngology | 644 Red Oak Lane, Fredericksburg, TX 78624 | 2012-02-21 |
| 1366676447 | Pamela Elaine Hansen | Counselor | 607 Pesimmon Ct., Fredericksburg, TX 78624 | 2009-05-05 |
| 1457526048 | Celine Bicquart Ord | Radiology | 753 S Washington St Bldg D, Fredericksburg, TX 78624 | 2008-04-24 |
| 1669669024 | Rebecca S Prescott | Dentist | 408 N Milam St, Fredericksburg, TX 78624 | 2007-10-01 |
| 1407046626 | Charles Richard Massey Jr. | General Practice | 103 Goehmann Lane, Fredericksburg, TX 78624 | 2007-07-25 |
| Find all providers in zip 78624 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
| City | FREDERICKSBURG |
| Zip Code | 78624 |
Please comment or provide details below to improve the information on FREDERICKSBURG LTC.
| 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.