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ASCENSION PROVIDENCE
NPI 1386784304
Pharmacy - Community/Retail Pharmacy in Waco, TX

Active since February 07, 2007CLIA Certified · 5 labs
405 LONDONDERRY DR STE 104, WACO, TX 76712(254) 751-4915(254) 751-4916 Get Directions Write a Review

NPPES record last updated: September 16, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 16, 2025, Feb 15, 2022, Apr 12, 2019 and 1 more (4 updates tracked since 2016).

About Ascension Providence NPPES

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

ASCENSION PROVIDENCE (NPI 1386784304), doing business as Ascension Providence Plaza Outpatient Pharmacy, is a healthcare organization registered as a community/retail pharmacy in Waco, Texas and active in the NPI registry since February 2007. The organization holds 5 active CLIA laboratory certificates and lists Julie L Holly, Reg Dir Net Rev & Reimb, as its authorized official.

NPPES Registry Identity

NPI1386784304
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameASCENSION PROVIDENCE
Location Address405 LONDONDERRY DR STE 104Waco, TX 76712-7920
Mailing Address405 Londonderry Dr Ste 104Waco, TX 76712-7920 · (254) 751-4915 · Fax (254) 751-4916
Phone(254) 751-4915
Fax(254) 751-4916
Organization SubpartNo
Authorized OfficialJulie L HollyReg Dir Net Rev & Reimb · (210) 410-2789
Enumeration DateFebruary 7, 2007
Last NPPES UpdateSeptember 16, 20254 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2025
✔ NPI 1386784304 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in TX · 14491
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
405 LONDONDERRY DR STE 104, Waco, TX 76712
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Other Names 1

Doing Business AsAscension Providence Plaza Outpatient Pharmacy

Other Identifiers 2

Medicaid370017TX
Other2099862Pk

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 Arkansas Health & Wellness and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 5

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 Accreditation 45D0685591

Ascension Providence/ Pulm Lab · Waco, TX
Active · expires Oct 21, 2028
CLIA Number45D0685591
Laboratory TypeHospital
Certificate Effective DateOctober 22, 2026
Certificate Expiration DateOctober 21, 2028
Laboratory DirectorDr. Matthew Pattillo
Laboratory Phone(254) 751-4230
Laboratory LocationAscension Providence/ Pulm Lab6901 Medical Parkway, Waco, TX 76712
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Accreditation 45D2287851

Ascension Providence Point Of Care · Waco, TX
Active · expires Mar 31, 2028
CLIA Number45D2287851
Laboratory TypeHospital
Certificate Effective DateApril 1, 2026
Certificate Expiration DateMarch 31, 2028
Laboratory DirectorChristine W. Rupcich
Laboratory Phone(254) 751-4000
Laboratory LocationAscension Providence Point Of Care6901 Medical Parkway,nursing Administration, 1st Floor, Waco, TX 76712
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 45D2014656

Ascension Providence Pediatric Clinic Woodway Medical Plaza · Waco, TX
Active · expires Sep 11, 2027
CLIA Number45D2014656
Laboratory TypePhysician Office
Certificate Effective DateSeptember 12, 2025
Certificate Expiration DateSeptember 11, 2027
Laboratory DirectorKelly Jaish
Laboratory Phone(254) 537-6400
Laboratory LocationAscension Providence Pediatric Clinic Woodway Medical Plaza6101 Woodway Drive, Ste 130, Waco, TX 76712
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 45D2101607

Ascension Providence Endorinology Clinic · Waco, TX
Active · expires Sep 3, 2027
CLIA Number45D2101607
Laboratory TypeHospital
Certificate Effective DateSeptember 4, 2025
Certificate Expiration DateSeptember 3, 2027
Laboratory DirectorAnna I. Vanderheiden
Laboratory Phone(254) 537-6530
Laboratory LocationAscension Providence Endorinology Clinic405 Londonberry Dr, Ste 301, Waco, TX 76712
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 45D0488500

Ascension Providence · Waco, TX
Active · expires Jan 2, 2027
CLIA Number45D0488500
Laboratory TypeHospital
Certificate Effective DateJanuary 3, 2025
Certificate Expiration DateJanuary 2, 2027
Laboratory DirectorDr. Christine W. Rupcich
Laboratory Phone(817) 751-4720
Laboratory LocationAscension Providence6901 Medical Parkway Attn: Laboratory, Waco, TX 76712
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 2

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

MEDICRX
Pharmacy (Community/Retail Pharmacy)
405 LONDONDERRY DR STE 104
WACO, TX 76712
McLennan County (325) 202-4015
DR. RHONDA CATE PHARMD
Pharmacist
405 LONDONDERRY DR STE 104
WACO, TX 76712
McLennan County (254) 751-4915

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 Ascension Providence's NPI number?

The NPI number for Ascension Providence is 1386784304. It was assigned to this organization in the NPPES registry on February 7, 2007. The provider is doing business as Ascension Providence Plaza Outpatient Pharmacy.

Where is Ascension Providence located?

Ascension Providence is located at 405 Londonderry Dr Ste 104, Waco, TX 76712. The listed phone number is (254) 751-4915.

What is Ascension Providence's specialty?

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

Does Ascension Providence hold CLIA laboratory certificates?

Yes. 5 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Ascension Providence accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 55 other insurers list Ascension Providence 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 Ascension Providence was last updated on September 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.