MEDI-DRIVE PHARMACY LLC NPI 1962687251

NPI Information

  • NPI: 1962687251
  • Provider Name: MEDI-DRIVE PHARMACY LLC
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Address: 507 23RD ST
    CANYON, TX
    ZIP 79015
  • Phone: (806) 655-1024

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NPI Details

MEDI-DRIVE PHARMACY LLC is a pharmacy in Canyon, 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. MEDI-DRIVE PHARMACY LLC NPI is 1962687251. The provider is registered as an organization entity type.

The provider's business location address is:

507 23RD ST
CANYON, TX
ZIP 79015-043
Phone: (806) 655-1024
Fax: (806) 655-9762

The provider's authorized official is Angela Klaire Bazaldua .
The authorized official title is Pic and has the following contact phone number (806) 655-1024.

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.

  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)

The enumeration date for this NPI number is 1/4/2008 and was last updated on 10/31/2025.

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
13336L0003XPharmacyLong Term Care PharmacyNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
3333600000XPharmacy31118TEXASYes

Other Identifiers

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

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12162163OTHERPK

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: 11/21/2025

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