Provider Demographics
NPI:1346316213
Name:TOPS PHARMACY SERVICES - AUSTIN SOUTH
Entity Type:Organization
Organization Name:TOPS PHARMACY SERVICES - AUSTIN SOUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:ERNEST
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-490-2912
Mailing Address - Street 1:PO BOX 731145
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-1145
Mailing Address - Country:US
Mailing Address - Phone:972-997-8103
Mailing Address - Fax:469-467-2535
Practice Address - Street 1:4101 JAMES CASEY ST
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-3325
Practice Address - Country:US
Practice Address - Phone:512-416-5132
Practice Address - Fax:512-462-9751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20029183500000X, 1835X0200X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No1835X0200XPharmacy Service ProvidersPharmacistOncologyGroup - Single Specialty