1. Home
  2. Directory
  3. Texas
  4. Bacliff
  5. Pharmacy
  6. NPI Profile

SULLIVAN PHARMACY
NPI 1093726580
Pharmacy - Community/Retail Pharmacy in Bacliff, TX

Active since August 10, 2006CLIA 45D2027184 · Waiver
1140 GRAND AVE, BACLIFF, TX 77518(281) 339-4577(281) 559-4339 Get Directions Write a Review

NPPES record last updated: July 27, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 27, 2020, Jun 22, 2020, May 6, 2020 and 1 more (4 updates tracked since 2019).

About Sullivan Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SULLIVAN PHARMACY (NPI 1093726580) is a healthcare organization registered as a community/retail pharmacy in Bacliff, Texas and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through December 27, 2026 and lists Rodolfo Rangel, Owner/pharmacist, as its authorized official.

NPPES Registry Identity

NPI1093726580
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSULLIVAN S DRUG LLC
Location Address1140 GRAND AVEBacliff, TX 77518-2760
Mailing Address1140 Grand AveBacliff, TX 77518-2760 · (281) 339-4577 · Fax (281) 559-4339
Phone(281) 339-4577
Fax(281) 559-4339
Organization SubpartNo
Authorized OfficialRodolfo RangelOwner/pharmacist · (956) 793-3738
Enumeration DateAugust 10, 2006
Last NPPES UpdateJuly 27, 20204 updates tracked since enumeration
NPPES CertifiedJuly 27, 2020
✔ NPI 1093726580 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in TX · 13309
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
1140 GRAND AVE, Bacliff, TX 77518
Open in Google Maps ↗

Other Names 1

Doing Business AsSullivan Pharmacy

Other Identifiers 2

Medicaid150045TX
Other4577219Ncpdp Provider Identification Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2027184

Sullivan Pharmacy · Bacliff, TX
Active · expires Dec 27, 2026
CLIA Number45D2027184
Laboratory TypePharmacy
Certificate Effective DateDecember 28, 2024
Certificate Expiration DateDecember 27, 2026
Laboratory DirectorJoe D. Sullivan
Laboratory Phone(281) 339-4577
Laboratory LocationSullivan Pharmacy1140 Grand Avenue, Bacliff, TX 77518
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
46 services46 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
44 services44 patients

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SULLIVAN S DRUG LLC
Durable Medical Equipment & Medical Supplies
1140 GRAND AVE
BACLIFF, TX 77518
Galveston County (281) 339-4577
SANDRA EVANS WEBB RPH
Pharmacist
1140 GRAND AVE
BACLIFF, TX 77518
Galveston County (281) 339-4577
CHRISTOPHER DEMMECK PHARMD
Pharmacist
1140 GRAND AVE
BACLIFF, TX 77518
Galveston County (281) 339-4577
LESLIE WILLIAMS
Pharmacist
1140 GRAND AVE
BACLIFF, TX 77518
Galveston County (281) 339-4577

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sullivan S Drug LLC's NPI number?

The NPI number for Sullivan S Drug LLC is 1093726580. It was assigned to this organization in the NPPES registry on August 10, 2006. The provider is doing business as Sullivan Pharmacy.

Where is Sullivan S Drug LLC located?

Sullivan S Drug LLC is located at 1140 Grand Ave, Bacliff, TX 77518. The listed phone number is (281) 339-4577.

What is Sullivan S Drug LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Sullivan S Drug LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2027184) is associated with this NPI, valid through December 27, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Sullivan S Drug LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 56 other insurers list Sullivan S Drug LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sullivan S Drug LLC was last updated on July 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.