NPI Code Details Logo

NPI 1942215587

NPI 1942215587 : MARTIN TIPTON PHARMACY LLC : AMARILLO, TX

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1942215587
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    MARTIN TIPTON PHARMACY LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    07/30/2006
-----------------------------------------------------
    Last Update Date     |    09/19/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1501 S TYLER ST 
-----------------------------------------------------
    City                 |    AMARILLO
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    79101-4240
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    806-373-2812
-----------------------------------------------------
    Fax                  |    806-372-6550
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    PO BOX 30863 
-----------------------------------------------------
    City                 |    AMARILLO
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    79120-0863
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    806-373-2812
-----------------------------------------------------
    Fax                  |    806-372-6550
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    PRESIDENT
-----------------------------------------------------
    Name                 |     J MARK  VOGLER 
-----------------------------------------------------
    Credential           |    PHARMD
-----------------------------------------------------
    Telephone            |    806-373-2812
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    332B00000X
-----------------------------------------------------
    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    332BC3200X
-----------------------------------------------------
    Taxonomy Name        |    Customized Equipment (DME)
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    332BX2000X
-----------------------------------------------------
    Taxonomy Name        |    Oxygen Equipment & Supplies (DME)
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
    Taxonomy Code        |    333600000X
-----------------------------------------------------
    Taxonomy Name        |    Pharmacy
-----------------------------------------------------
    License Number       |    99-6012
-----------------------------------------------------
    License Number State |    OK
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
    Taxonomy Code        |    3336C0004X
-----------------------------------------------------
    Taxonomy Name        |    Compounding Pharmacy
-----------------------------------------------------
    License Number       |    19969
-----------------------------------------------------
    License Number State |    TX
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
    Taxonomy Code        |    3336H0001X
-----------------------------------------------------
    Taxonomy Name        |    Home Infusion Therapy Pharmacy
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
    Taxonomy Code        |    3336L0003X
-----------------------------------------------------
    Taxonomy Name        |    Long Term Care Pharmacy
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #8
-----------------------------------------------------
    Taxonomy Code        |    3336C0003X
-----------------------------------------------------
    Taxonomy Name        |    Community/Retail Pharmacy
-----------------------------------------------------
    License Number       |    PH00003537
-----------------------------------------------------
    License Number State |    NM
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.