Provider Demographics
NPI:1437295052
Name:AS PHARMACY L.L.C.
Entity Type:Organization
Organization Name:AS PHARMACY L.L.C.
Other - Org Name:HILL COUNTRY APOTHECARY - RIVERPLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:METCALF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-637-2030
Mailing Address - Street 1:6611 RIVER PLACE BLVD
Mailing Address - Street 2:STE 103
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730-1162
Mailing Address - Country:US
Mailing Address - Phone:512-487-5759
Mailing Address - Fax:512-487-5772
Practice Address - Street 1:6611 RIVER PLACE BLVD STE 103
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78730-1170
Practice Address - Country:US
Practice Address - Phone:512-487-5759
Practice Address - Fax:512-487-5772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
TX288423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2103831OtherPK
TX143310Medicaid
1196740001Medicare NSC