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SULLIVAN PHARMACY
NPI 1215064340
Durable Medical Equipment & Medical Supplies in Bacliff, TX

Active since February 27, 2007CLIA 45D2027184 · Waiver
1140 GRAND AVE, BACLIFF, TX 77518(281) 339-4577(281) 559-4339 Get Directions Write a Review

NPPES record last updated: June 22, 2020. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Jun 22, 2020, May 13, 2020, May 6, 2020 (3 updates tracked since 2020).

About Sullivan Pharmacy NPPES

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

SULLIVAN PHARMACY (NPI 1215064340) is a healthcare organization registered as a durable medical equipment & medical supplies in Bacliff, Texas and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through December 27, 2026 and lists Rodolfo Rangel, Owner, as its authorized official.

NPPES Registry Identity

NPI1215064340
Entity TypeOrganization
Primary Taxonomy332B00000X
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 · (956) 793-3738
Enumeration DateFebruary 27, 2007
Last NPPES UpdateJune 22, 20203 updates tracked since enumeration
NPPES CertifiedJune 22, 2020
✔ NPI 1215064340 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
License✔ Licensed in TX · 13309
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
1140 GRAND AVE, Bacliff, TX 77518
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Other Names 1

Doing Business AsSullivan Pharmacy

Other Identifiers 2

Medicaid011509901TX
Medicaid010086901TX

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.

Medical Equipment Supplier Medicare DMEPOS 2

Medicare supplier enrollment and the product categories Sullivan Pharmacy carries, from the Medicare DMEPOS supplier directory.

Sullivan Pharmacy

DMEPOS supplier · Bacliff, TXOperated by Sullivan S Drug LLC
✔

Accepts Medicare assignment

Sullivan Pharmacy agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20413643
Medicare Participant SinceJune 8, 2020
Supplier Location1140 Grand AveBacliff, TX 77518
Phone(281) 339-4577
Supplier Specialties
Pharmacy

Medicare Product Categories

Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

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
Pharmacy (Community/Retail Pharmacy)
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 1215064340. It was assigned to this organization in the NPPES registry on February 27, 2007. 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 Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Does Sullivan S Drug LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Sullivan Pharmacy accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

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.

When was this NPI record last updated?

The NPPES record for Sullivan S Drug LLC was last updated on June 22, 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.