Provider Demographics
NPI:1982280160
Name:LIFECARE PHARMACY 23 INC
Entity type:Organization
Organization Name:LIFECARE PHARMACY 23 INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUPNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-241-6337
Mailing Address - Street 1:4500 S PLEASANT VALLEY RD # 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78744-2911
Mailing Address - Country:US
Mailing Address - Phone:512-648-2700
Mailing Address - Fax:908-634-4038
Practice Address - Street 1:4500 S PLEASANT VALLEY RD # 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78744-2911
Practice Address - Country:US
Practice Address - Phone:512-648-2700
Practice Address - Fax:908-634-4038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149304Medicaid