MEDICARE: LIFECARE PHARMACY 23 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	3336C0003X	Community/Retail Pharmacy
2	333600000X	Pharmacy	30398	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2158289	OTHER		PK

General Provider Information

NPI Number	:	1689035545
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFECARE PHARMACY 23 INC

Provider Business Mailing Address
First Line	:	4500 S PLEASANT VALLEY RD # 100
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78744-2911
Country	:	US
Telephone Number	:	512-648-2700
Fax Number	:	908-634-4038

Provider Business Practice Location Address
First Line	:	4500 S PLEASANT VALLEY RD # 100
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78744-2911
Country	:	US
Telephone Number	:	512-648-2700
Fax Number	:	908-634-4038

Authorized Official
Title or Position	:	OWNER
Name	:	JOEL ZUPNICK
Credential	:
Telephone Number	:	908-241-6337

Provider Enumeration Date	:	03/18/2016
Last Update Date	:	11/19/2025

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Directions to “LIFECARE PHARMACY 23 INC ” Practice Location

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