RED RIVER PHARMACY LONG TERM CARE, LLC (NPI# 1447500590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447500590 |
| Entity Type | Organization |
| Organization Name | RED RIVER PHARMACY LONG TERM CARE, LLC |
| Other Organization Name | RED RIVER LTC OF TYLER |
| Practice Address |
4801 Troup Hwy Suite 402 Tyler TX 75703-2356 |
| Mailing Address |
1550 Moores Ln Ste A Texarkana TX 75503-4657 |
| Practice Telephone | 9036176885 |
| Practice Fax Number | 9036176972 |
| Mailing Telephone | 9036176885 |
| Mailing Fax Number | 9036176972 |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2020-10-30 |
| Authorized Official Name | MR. DAVID BOUDREAUX (PRESIDENT/OWNER) |
| Authorized Official Telephone | 9037921721 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
28138 | TX | Suppliers |
| Other Name | Type Code |
|---|---|
| Red River LTC of Tyler | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497317366 | Red River Pharmacy Long Term Care, LLC | Home Infusion | 4801 Troup Hwy Ste 401, Tyler, TX 75703-2358 | 2019-07-01 |
| 1407106578 | Red River Pharmacy Long Term Care, LLC | Pharmacy | 1550 Moores Ln Ste A, Texarkana, TX 75503-4657 | 2012-09-14 |
| Street Address |
4801 TROUP HWY SUITE 402 |
| City | TYLER |
| State | TX |
| Zip Code | 75703-2356 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679564314 | Vivian S Kemp | Counselor | 4801 Troup Hwy, Suite 301, Tyler, TX 75703-2356 | 2005-11-02 |
| 1952707556 | Wilson Renfroe, Psyd, Pllc | Psychologist | 4801 Troup Hwy, Suite 502, Tyler, TX 75703-2356 | 2014-11-08 |
| 1144622283 | Veronika Bailey | Speech-Language Pathologist | 4801 Troup Hwy, Ste 800, Tyler, TX 75703-2356 | 2014-09-19 |
| 1407191349 | Louise Ann Star | Occupational Therapy Assistant | 4801 Troup Hwy, Suite800, Tyler, TX 75703-2356 | 2012-12-04 |
| 1295070472 | Martha Phillips | Occupational Therapy Assistant | 4801 Troup Hwy, Suite 800, Tyler, TX 75703-2356 | 2012-11-29 |
| 1891049045 | Shauna Kay Brown | Occupational Therapist | 4801 Troup Hwy, Suite 800, Tyler, TX 75703-2356 | 2012-11-08 |
| 1750635322 | Chelsey Nicole Hoffman | Physical Therapist | 4801 Troup Hwy, Suite 800, Tyler, TX 75703-2356 | 2012-11-05 |
| 1972853513 | Alicen Stegall Taylor | Speech-Language Pathologist | 4801 Troup Hwy, Suite 800, Tyler, TX 75703-2356 | 2012-09-11 |
| 1093064503 | Hannah Elisabeth Osborne | Occupational Therapist | 4801 Troup Hwy, Suite 800, Tyler, TX 75703-2356 | 2012-08-30 |
| 1346597085 | Bobbie Darlene Groves | Speech-Language Pathologist | 4801 Troup Hwy, Suite 800, Tyler, TX 75703-2356 | 2012-08-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
| 1770052532 | Refinery Chiropractic LLC | Chiropractor | 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 | 2018-11-21 |
| 1215419353 | Deidre Lynn Fergason | Occupational Therapy Assistant | 3505 Old Jacksonville Hwy, Tyler, TX 75703 | 2018-09-05 |
| 1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
| 1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
| 1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
| 1427572544 | Cody Wayne Graham | Pharmacist | 5415 S. Broadway Ave., Tyler, TX 75703 | 2017-07-31 |
| 1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
| 1427570084 | Darah Lynne Dahlem | Speech-Language Pathologist | 401 E. Front Street Ste 123, Tyler, TX 75703 | 2017-07-14 |
| 1194267468 | Herman Lester Hampton Jr. | Surgery | 5803 Regents Row, Tyler, TX 75703 | 2016-11-17 |
| Find all providers in zip 75703 | ||||
| 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 |
|---|---|---|---|---|
| 1942793591 | Qltc Pharmacy Solutions, LLC | Pharmacy | 4285 Chandler Hwy, Tyler, TX 75702-7604 | 2018-06-08 |
| 1104240068 | Brickstreet Long Term Care, LLC | Pharmacy | 312 W Rusk St, Suite B, Tyler, TX 75701-1513 | 2014-02-13 |
| 1396774071 | Omnicare Pharmacy of Texas 2, Lp | Pharmacy | 105 Jordan Plaza Blvd, Tyler, TX 75704-2048 | 2006-07-03 |
| 1295373405 | Donald J. Meyers | Pharmacy | 1863 Troup Hwy, Tyler, TX 75701-5871 | 2019-12-18 |
| 1861685851 | Thrifty Drug Stores Inc | Pharmacy | 183 N Tyler St, Tyler, MN 56178-1160 | 2007-08-22 |
| 1588730493 | Genoa Healthcare, LLC | Pharmacy | 2323 W Front St, Tyler, TX 75702-7704 | 2006-11-24 |
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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.