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DERAMED SPECIALTY PHARMACY NPI 1164997169


NPI Information

NPI: 1164997169
Provider Name: DERAMED SPECIALTY PHARMACY

Doing Business As: DERHANN CO. LLC

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 45D2161083

Address:
1001 MATLOCK RD STE 105
MANSFIELD, TX
ZIP 76063
Phone: (817) 592-3636
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DERAMED SPECIALTY PHARMACY is a pharmacy in Mansfield, TX. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. DERAMED SPECIALTY PHARMACY NPI is 1164997169. The provider is registered as an organization entity type.
The provider Is Doing Business As Derhann Co. Llc.

The provider's business location address is:

1001 MATLOCK RD STE 105
MANSFIELD, TX
ZIP 76063-443
Phone: (817) 592-3636

The provider's authorized official is Aderonke Efunogbon .
The authorized official title is Director and has the following contact phone number (817) 592-3636.

The CLIA number assigned to this NPI record is 45D2161083 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/5/2018 and was last updated on 11/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
33336C0004XPharmacyCompounding PharmacyNo
43336L0003XPharmacyLong Term Care PharmacyNo
53336S0011XPharmacySpecialty PharmacyNo
6333600000XPharmacyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.