Provider Demographics
NPI:1417126640
Name:PHARMACIST ON DEMAND LLC
Entity Type:Organization
Organization Name:PHARMACIST ON DEMAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACY MANAGER PIC
Authorized Official - Prefix:MR
Authorized Official - First Name:MUFID
Authorized Official - Middle Name:N
Authorized Official - Last Name:NAJJAR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:512-249-7500
Mailing Address - Street 1:8650 SPICEWOOD SPRINGS RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4322
Mailing Address - Country:US
Mailing Address - Phone:512-249-7500
Mailing Address - Fax:512-249-7512
Practice Address - Street 1:8650 SPICEWOOD SPRINGS RD
Practice Address - Street 2:SUITE 106
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4322
Practice Address - Country:US
Practice Address - Phone:512-249-7500
Practice Address - Fax:512-249-7512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25905333600000X, 3336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacyGroup - Single Specialty
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1417126640Medicaid
TXT0156801OtherDPS
TX25905OtherSTATE LICENSE
TX2JNP49A00OtherHIN
TX2JNP49A00OtherHIN
TX7165150001Medicare NSC
TX25905OtherSTATE LICENSE