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Contact Information

TARRYTOWN PHARMACY LLC
2727 EXPOSITION BLVD
STE 105
AUSTIN, TX78703-1228
 Phone: 512-478-6419
 Fax: 512-478-1638
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Diabetes Educator

163WD0400X
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Pharmacist

183500000X
 

Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

1835P0018X
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Primary Care

261QP2300X
Indicates primary specialty

NPI Profile & details for TARRYTOWN PHARMACY LLC

NPI # 1942384078
LBN Legal business name TARRYTOWN PHARMACY LLC
Authorized official MARK NEWBERRY - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 10/25/2006
Last updated 08/31/2022 - About 4 years ago
Identifiers
TX License # 1812
TX Medicaid 110162
Other 2093490 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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