Healthcare Provider Details

I. General information

NPI: 1689035545
Provider Name (Legal Business Name): LIFECARE PHARMACY 23 INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2016
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 S PLEASANT VALLEY RD # 100
AUSTIN TX
78744-2911
US

IV. Provider business mailing address

4500 S PLEASANT VALLEY RD # 100
AUSTIN TX
78744-2911
US

V. Phone/Fax

Practice location:
  • Phone: 512-648-2700
  • Fax: 908-634-4038
Mailing address:
  • Phone: 512-648-2700
  • Fax: 908-634-4038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number30398
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOEL ZUPNICK
Title or Position: OWNER
Credential:
Phone: 908-241-6337