PRODIGIOUS INDUSTRIES LLC NPI 1477819266

NPI Details

PRODIGIOUS INDUSTRIES LLC is a pharmacy in Mesquite, 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. PRODIGIOUS INDUSTRIES LLC NPI is 1477819266. The provider is registered as an organization entity type.
The provider Is Doing Business As Kearney Park Pharmacy.

The provider's business location address is:

3224 GUS THOMASSON RD
MESQUITE, TX
ZIP 75150-004
Phone: (972) 329-1168
Fax: (972) 329-1436

The provider's authorized official is Fronce Barnes .
The authorized official title is Pharmacist In Charge and has the following contact phone number (972) 329-1168.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Fee covid-19 vac 13 res (HCPCS:0124A)
• Influenza vaccine, quadrivalent, 0.5 ml dosage (HCPCS:90688)
• Administration of influenza virus vaccine (HCPCS:G0008)
• Adm sarscov2 30mcg/0.3ml bst (HCPCS:0004A)

The enumeration date for this NPI number is 4/5/2012 and was last updated on 8/22/2022.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.