LIFESPAN PHARMACY INC (NPI# 1477725398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477725398 |
| Entity Type | Organization |
| Organization Name | LIFESPAN PHARMACY INC |
| Other Organization Name | LIFESPAN PHARMACY |
| Practice Address |
1341 W Mockingbird Ln Suite 304w Dallas TX 75247 |
| Practice Telephone | 2142200007 |
| Practice Fax Number | 2142202850 |
| Mailing Telephone | 2142200007 |
| Mailing Fax Number | 2142202850 |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2018-08-16 |
| Authorized Official Name | GINA RENNA (OWNER/OFFICER) |
| Authorized Official Telephone | 2143031888 |
| Authorized Official Credential | PHARMACIST |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 333600000X | Pharmacy | TX | Suppliers | |
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
24217 | TX | Suppliers |
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
TX | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 4525688 | 01 |
| Other Name | Type Code |
|---|---|
| LIFESPAN PHARMACY | Doing Business As Name - Organization |
| Street Address |
1341 W MOCKINGBIRD LN SUITE 304W |
| City | DALLAS |
| State | TX |
| Zip Code | 75247 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346243151 | Michael C Fitzpatrick | Specialist | 1341 W Mockingbird Ln, Mockingbird Towers, Ste 710e, Dallas, TX 75247-6913 | 2005-05-24 |
| 1083247522 | Nina Anunobi | Nurse Practitioner | 1341 W Mockingbird Ln, Dallas, TX 75247-6913 | 2020-02-12 |
| 1770046807 | Willybroad Che | Nurse Practitioner | 1341 W Mockingbird Ln, Dallas, TX 75247-6913 | 2019-04-06 |
| 1417322157 | Premiere Counseling and Recovery Services | Counselor | 1341 W Mockingbird Ln, Suite 600, West Tower, Dallas, TX 75247-6913 | 2015-12-07 |
| 1215241211 | John G Mchenry Md Mph Pllc | Ophthalmology | 1341 W Mockingbird Ln, Suite 241, Dallas, TX 75247-6913 | 2010-08-02 |
| 1811223993 | Carestaf of Dallas, Lp | Home Health | 1341 W Mockingbird Ln, Suite 242w, Dallas, TX 75247-6913 | 2009-10-26 |
| 1588899256 | Peter Choi | Internal Medicine | 1341 W Mockingbird Ln, Suite 240e, Dallas, TX 75247-4971 | 2009-05-24 |
| 1073654661 | Marcus M Stavchansky | Pharmacist | 1341 W Mockingbird Ln, Suite #400 E, Dallas, TX 75247-6913 | 2007-02-08 |
| 1548310691 | Bahar Anbar | Physician Assistant | 1341 W Mockingbird Ln, Mockingbird Towers, Ste 710e, Dallas, TX 75247-6913 | 2007-01-11 |
| 1104975655 | Jeanelle Leilani Kam | Obstetrics & Gynecology | 1341 W Mockingbird Ln, Suite 200 E, Dallas, TX 75247-6913 | 2007-01-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558973842 | Paramount Medical Rehabilitation LLC | Clinic/Center | 8585 North Stemmons Freeway Ste 107-s, Dallas, TX 75247 | 2020-08-19 |
| 1750916144 | Sunshine Kids Pediatric Day Center, LLC | Nursing Care | 9127-9131 King Arthur Boulevard, Dallas, TX 75247 | 2020-03-06 |
| 1740789924 | Jennifer Pauli | Nurse Practitioner | 7610 N Stemmons Fwy Ste 360, Dallas, TX 75247 | 2018-02-02 |
| 1669991097 | Kai Medical Laboratories, LLC | Pathology | 8230 Elmbrook Dr Ste 200, Dallas, TX 75247 | 2017-09-18 |
| 1174055610 | Hoa Perkins | Technician/Technologist | 1499 Regal Row Suite 505a, Dallas, TX 75247 | 2017-04-03 |
| 1376910018 | Integron LLC | Clinical Medical Laboratory | 5139 Sharp Street, Dallas, TX 75247 | 2015-08-28 |
| 1710364575 | T.e.a.m. | Community/Behavioral Health | 1140 Empire Central Blvd, 520, Dallas, TX 75247 | 2015-04-30 |
| 1093053126 | Guardian Health Systems Aurora | Pharmacy | 7920 Elmbrook Drive Suite 108, Suite 108, Dallas, TX 75247 | 2013-01-24 |
| 1457665317 | Pediatric Home Healthcare, LLC | Home Health | 1341 W Mockingbird Ln Ste 245e, Dallas, TX 75247 | 2010-08-03 |
| 1275846388 | Another Chancee, Inc. | Social Worker | 1140 Empire Central Drive, Suite 260, Dallas, TX 75247 | 2010-07-17 |
| Find all providers in zip 75247 | ||||
| Taxonomy Code | 3336S0011X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Specialty Pharmacy |
| A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. |
| 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] |
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| 1922069525 | Ivedco, LLC | Pharmacy | 4950 Westgrove Dr, Dallas, TX 75248-1924 | 2006-03-31 |
| 1376151704 | Abdul Hameed | Pharmacy | 4309 Lemmon Ave, Dallas, TX 75219-2706 | 2020-07-22 |
| 1972012128 | Tri County Compounding Inc | Pharmacy | 111a N Hoffman St, Dallas, NC 28034-1597 | 2017-09-20 |
| 1104233030 | Pharmacy Preferred Physicians, LLC | Pharmacy | 17300 Dallas Pkwy, Suite 1080a, Dallas, TX 75248-1145 | 2014-07-11 |
| 1972800167 | Envoyrx LLC | Pharmacy | 2929 Carlisle St, Suite 115, Dallas, TX 75204-1084 | 2011-02-24 |
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| 1194378000 | Recept Pharmacy, Lp | Pharmacy | 209 Saint Louis Ave Ste 101, Fort Worth, TX 76104-1231 | 2019-07-19 |
| 1497314132 | Zikam Neighborhood Pharmacy LLC | Pharmacy | 17323 Ih 35 N Ste 100, Schertz, TX 78154-1278 | 2019-06-06 |
| 1932692571 | Bsa Harrington Physicians Inc | Pharmacy | 1500 Wallace Blvd Ste B, Amarillo, TX 79106-1794 | 2018-06-08 |
| 1154810760 | Doughertys Pharmacy Legacy LLC | Pharmacy | 6501 Legacy Dr Ste P, Plano, TX 75024-3612 | 2018-05-09 |
| 1578075974 | Ab Pharmacy Inc. | Pharmacy | 1401 E. Ridge Rd, Unit-b, Mcallen, TX 78503-1525 | 2017-10-26 |
| 1629589536 | Ab Pharmacy Inc. | Pharmacy | 1401 E. Ridge Rd, Unit-b, Unit-b, Mcallen, TX 48503-1525 | 2017-10-18 |
| 1346759651 | Inkrx,llc | Pharmacy | 11398 Bandera Rd Ste 302, San Antonio, TX 78250-6843 | 2017-09-29 |
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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.