Provider Demographics
NPI:1013082692
Name:AMERICARE PHARMACY INC
Entity Type:Organization
Organization Name:AMERICARE PHARMACY INC
Other - Org Name:AMERICARE PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:FLANAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:940-668-6868
Mailing Address - Street 1:217 N WEAVER ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76240-3953
Mailing Address - Country:US
Mailing Address - Phone:940-668-6868
Mailing Address - Fax:940-668-1899
Practice Address - Street 1:217 N WEAVER ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-3953
Practice Address - Country:US
Practice Address - Phone:940-668-6868
Practice Address - Fax:940-668-1899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX159323336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2104148OtherPK
TX144127Medicaid
0990470001Medicare NSC