MEDICARE: CENTRAL PHARMACY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	11072	TX
2	332BC3200X	Customized Equipment (DME)	11072	TX
3	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	11072	TX
4	332BX2000X	Oxygen Equipment & Supplies (DME)	11072	TX
5	333600000X	Pharmacy	11072	TX
6	3336C0003X	Community/Retail Pharmacy	11072	TX
7	3336H0001X	Home Infusion Therapy Pharmacy	11072	TX
8	3336L0003X	Long Term Care Pharmacy	11072	TX
9	3336M0002X	Mail Order Pharmacy	11072	TX
10	3336S0011X	Specialty Pharmacy	11072	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	519955	OTHER	TX	BCBS-DME
2	750662	OTHER	TX	BCBS-HIT

General Provider Information

NPI Number	:	1265466155
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL PHARMACY, INC.

Provider Business Mailing Address
First Line	:	314 N 5TH ST
Second Line	:
City	:	CARRIZO SPRINGS
State	:	TX
Zip	:	78834-3106
Country	:	US
Telephone Number	:	830-876-2516
Fax Number	:	830-876-5450

Provider Business Practice Location Address
First Line	:	314 N 5TH ST
Second Line	:
City	:	CARRIZO SPRINGS
State	:	TX
Zip	:	78834-3106
Country	:	US
Telephone Number	:	830-876-2516
Fax Number	:	830-876-5450

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RICHARD L DOBLE
Credential	:
Telephone Number	:	830-876-2516

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	09/11/2025

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