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SOUTHLAND LEGEND PHARMACY
NPI 1225142219
Pharmacy - Community/Retail Pharmacy in Tyler, TX

Active since August 18, 2006
5201 S BROADWAY AVE, STE 100, TYLER, TX 75703(903) 534-8218(903) 534-2897 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Southland Legend Pharmacy NPPES

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

SOUTHLAND LEGEND PHARMACY (NPI 1225142219) is a healthcare organization registered as a community/retail pharmacy in Tyler, Texas and active in the NPI registry since August 2006. The organization lists Doug Benedetti, Pic, as its authorized official.

NPPES Registry Identity

NPI1225142219
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSOUTHLAND LEGEND PHARMACY
Location Address5201 S BROADWAY AVE, STE 100Tyler, TX 75703-3748
Mailing Address5201 S Broadway Ave, Ste 100Tyler, TX 75703-3748
Phone(903) 534-8218
Fax(903) 534-2897
Organization SubpartNo
Authorized OfficialDoug BenedettiPic · (903) 534-8218
Enumeration DateAugust 18, 2006
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1225142219 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
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.
Also ListedPharmacyTaxonomy 333600000X · License 17039 (TX)
5201 S BROADWAY AVE, Tyler, TX 75703
Open in Google Maps ↗

Other Identifiers 2

Medicaid144423TX
Other4572093Other Id Number-commercial Number

Other Providers at the Same Location NPPES 6

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

TIMES SQUARE FAMILY DENTAL PA
Dentist (General Practice)
5201 S BROADWAY AVE, SUITE 240
TYLER, TX 75703
Smith County (903) 534-8110
TY BLACK DDS
Dentist
5201 S BROADWAY AVE, ST 240
TYLER, TX 75703
Smith County (903) 534-8110
ALLIED PAIN MANAGEMENT CLINIC P.A.
Family Medicine
5201 S BROADWAY AVE, SUITE 200
TYLER, TX 75703
Smith County (903) 595-6078
ALLIED PAIN MANAGEMENT CLINIC, P.A.
Chiropractor (Orthopedic)
5201 S BROADWAY AVE, STE 200
TYLER, TX 75703
Smith County (903) 595-6078
TYLER BEHAVIORAL HEALTH
Counselor (Professional)
5201 S BROADWAY AVE
TYLER, TX 75703
Smith County (214) 943-9431
DR. TY BRANDON BLACK DDS
Dentist (General Practice)
5201 S BROADWAY AVE, ST 240
TYLER, TX 75703
Smith County (903) 534-8110

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 Southland Legend Pharmacy's NPI number?

The NPI number for Southland Legend Pharmacy is 1225142219. It was assigned to this organization in the NPPES registry on August 18, 2006.

Where is Southland Legend Pharmacy located?

Southland Legend Pharmacy is located at 5201 S Broadway Ave Ste 100, Tyler, TX 75703. The listed phone number is (903) 534-8218.

What is Southland Legend Pharmacy's specialty?

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

When was this NPI record last updated?

The NPPES record for Southland Legend Pharmacy was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.