MP SOUTHPARK PHARMACY LLC
NPI 1427081447
Pharmacy - Long Term Care Pharmacy in San Angelo, TX
NPI Status: Active since July 10, 2006
Contact Information
29 S CHADB0URNE
SAN ANGELO, TX
ZIP 76903
Phone: (325) 655-3146
Fax: (325) 658-5891
- Organization
- Pharmacy
- Long Term Care Pharmacy
- Accepts Insurance
- Medicare Supplier
- Does Not Accept Medicare Approved Payment
- CLIA Number: 45D2247482
- CLIA Cert. Type: Pharmacy
- CLIA Exp. Date: 01-05-2026
About MP SOUTHPARK PHARMACY LLC
This page provides the complete NPI Profile along with additional information for Mp Southpark Pharmacy Llc, a provider established in San Angelo, Texas operating as a Pharmacy, focusing in long term care pharmacy . The healthcare provider is registered in the NPI registry with number 1427081447 assigned on July 2006. The practitioner's primary taxonomy code is 3336L0003X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's
- NPI
- 1427081447
- Provider Legal Name
- MP SOUTHPARK PHARMACY LLC
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 29 S CHADB0URNE SAN ANGELO, TX 76903
- Location Phone
- (325) 655-3146
- Location Fax
- (325) 658-5891
- Mailing Address
- 29 S CHADB0URNE SAN ANGELO, TX 76903
- Mailing Phone
- (325) 655-3146
- Mailing Fax
- (325) 658-5891
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-10-2006
- Last Update Date
- 09-12-2025
- Code Navigator
Mp Southpark Pharmacy Llc is a medicare supplier with PTAN 20460635 who does not accept Medicare assignment for all durable medical equipment and supplies. The provider may not accept the Medicare allowable as payment in full and may collect additional payment directly from the patient, and/or charge more than the Medicare allowable.The supplier carries the following product categories: Immunosuppressive Drugs or Nebulizer Drugs or Commodes, Urinals, Bedpans or Blood Glucose Monitors/Supplies (Non-Mail Order) or Hospital Beds (Electric) or Hospital Beds (Manual) or Support Surfaces: Pressure Reducing Beds/Mats/Pads or (TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies or Canes and/or Crutches or Patient Lifts or Power Operated Vehicles (Scooters) or Seat Lift Mechanisms or Walkers or Wheelchairs (Standard Manual) or Wheelchairs (Standard Manual Related Accessories) or Wheelchairs (Standard Power) or Wheelchairs (Standard Power Related Accessories) or Wheelchair Seating/Cushions or Orthoses: Prefabricated (Non-Custom Fabricated) or Orthoses: Off-The-Shelf or Breast Prostheses and/or Accessories or Tracheotomy Supplies or Urological Supplies or Enteral Nutrients or Enteral Equipment and/or Supplies or Nebulizer Equipment and/or Supplies or Respiratory Suction Pumps or Surgical Dressings or Lymphedema Compression Treatment Items.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy Long Term Care Pharmacy
- Taxonomy Code
- 3336L0003X
- Type
- Suppliers
- Taxonomy Description
- A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | |
| 2 | 3336C0003X | Suppliers | Pharmacy | 31522 (TX) |
| 3 | 3336C0004X | Suppliers | Pharmacy |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- AvMed Entrust Bronze 600 (2026) - HMO
- AvMed Entrust Bronze 650 (2026) - HMO
- AvMed Entrust Expanded Bronze Standard (2026) - HMO
- AvMed Entrust Gold 125 (2026) - HMO
- AvMed Entrust Gold 125 Dental+Vision (2026) - HMO
- AvMed Entrust Gold Standard (2026) - HMO
- AvMed Entrust Platinum 25 (2026) - HMO
- AvMed Entrust Platinum 25 Dental+Vision (2026) - HMO
- AvMed Entrust Platinum Standard (2026) - HMO
- AvMed Entrust Silver 350 (2026) - HMO
- BSW Diabetes Care Gold HMO 014 - HMO
- BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Elite Gold HMO 004 - HMO
- BSW Elite Gold HMO 012 - HMO
- BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Prime Silver HMO 008 - HMO
- BSW Prime Silver HMO 005 - HMO
- BSW Savers Bronze HMO H S A 006 - HMO
- BSW Savers Bronze HMO H S A 007 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Savers Bronze HMO H S A 009 - HMO
- my Blue Access Major Events Select PPO Catastrophic 10600 - 3 Free PCP Visits - PPO
- my Blue Access Select PPO Bronze 3800 - PPO
- my Blue Access Select PPO Bronze 3800 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Bronze 9200 - PPO
- my Blue Access Select PPO Gold 0 - PPO
- my Blue Access Select PPO Gold 0 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Gold 1700 HSA - PPO
- my Blue Access Select PPO Premier Gold 0 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Premier Platinum 0 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Premier Silver 0 + Adult Dental and Vision - PPO
- my Blue Access WV Major Events PPO Catastrophic 10600 - 3 Free PCP Visits - PPO
- my Blue Access WV PPO Bronze 3800 - PPO
- my Blue Access WV PPO Bronze 3800 + Adult Dental and Vision - PPO
- my Blue Access WV PPO Bronze 9200 - PPO
- my Blue Access WV PPO Gold 0 - PPO
- my Blue Access WV PPO Gold 0 + Adult Dental and Vision - PPO
- my Blue Access WV PPO Gold 1700 HSA - PPO
- my Blue Access WV PPO Premier Gold 0 - PPO
- my Blue Access WV PPO Premier Gold 0 + Adult Dental and Vision - PPO
- my Blue Access WV PPO Premier Silver 0 - PPO
- Humana Dental Smart Choice - PPO
- Humana Dental Smart Choice - High - PPO
- Humana Dental Smart Choice - Lite - PPO
- Humana Dental Smart Choice - Low - PPO
- Select by Medica Bronze $0 Copay PCP Visits - EPO
- Select by Medica Bronze Share - EPO
- Select by Medica Expanded Bronze Standard - EPO
- Select by Medica Gold $0 Copay PCP Visits - EPO
- Select by Medica Gold Share - EPO
- Select by Medica Gold Standard - EPO
- Select by Medica Silver $0 Copay PCP Visits - EPO
- Select by Medica Silver Share - EPO
- Select by Medica Silver Standard - EPO
- Moda Health Affinity Bronze 8000 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 31522 | OTHER (01) | TX | PHARMACY LICENSE |
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Administration of influenza virus vaccine
Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free
Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage
Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage
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.
This service was performed 322 times for 321 patientsThe quadrivalent influenza vaccine is a flu shot that protects against four different flu viruses. Derived from cell cultures, it is free of preservatives and antibiotics. It's a safe and effective way to reduce your risk of getting the flu.
This service was performed 11 times for 11 patientsThe quadrivalent inactivated influenza vaccine is a shot given to protect against four strains of the flu virus. This 0.5 ml dosage helps your body develop immunity to the virus. It's an important step in preventing flu-related complications.
This service was performed 295 times for 295 patientsThe quadrivalent influenza vaccine is a shot to protect you from four different flu viruses. It's preservative-free and given in a 0.5 ml dose. It helps your body build immunity to the flu, reducing your risk of getting sick.
This service was performed 15 times for 15 patientsMedical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20460635
- Accepts Medicare Assignment
- NO
- Specialities List
- Certified Other, Orthotic Personnel, Pharmacy.
- Competitive Bidding
- NO
Supplies List
- Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
- Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
- Commodes, Urinals, Bedpans - Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
- 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
- Hospital Beds (Electric) - Total electric hospital beds, Semi-electric hospital beds
- Hospital Beds (Manual) - Fixed height hospital beds, Variable height hospital beds
- Support Surfaces: Pressure Reducing Beds/Mats/Pads - Group 1 – Alternating pressure pad, Air/Water/Dry pressure pad or pressure mattress. Group 2 - Pressure reducing powered air mattresses, Powered air flotation bed, non-powered pressure reducing mattress Group 3 – Air fluidized bed
- (TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies - Transcutaneous Electrical Nerve Stimulation (TENS) for the relief of acute post-operative pain
- Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
- Patient Lifts - Ceiling lifts, Slings
- Power Operated Vehicles (Scooters) - Scooters
- Seat Lift Mechanisms - Lift chair
- Walkers - Standard Walkers, Wheeled Walkers, Folding Walker
- Wheelchairs (Standard Manual) - Standard wheelchairs, transport wheelchairs, heavy duty wheelchairs
- Wheelchairs (Standard Manual Related Accessories) - Accessories for standard wheelchairs, transport wheelchairs, heavy duty wheelchairs
- Wheelchairs (Standard Power) - Standard power wheelchairs, Heavy duty standard power wheelchairs
- Wheelchairs (Standard Power Related Accessories) - Accessories for standard power wheelchairs, heavy duty standard power wheelchairs
- Wheelchair Seating/Cushions - Wheelchair seat cushions, Wheelchair bank cushions, Wheelchair padded armrests
- Orthoses: Prefabricated (Non-Custom Fabricated) - Met pads, Heel pads, Heel spur pads
- Orthoses: Off-The-Shelf - Met pads, Heel pads, Heel spur pads
- Breast Prostheses and/or Accessories - Prosthetic bra, Surgical bra
- Tracheotomy Supplies - Tracheostomy care kits
- Urological Supplies - Catheters, Urinary collection devices
- Enteral Nutrients - Enteral formula
- Enteral Equipment and/or Supplies - Enteral infusion pumps, enteral nutrition supply kits
- Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
- Respiratory Suction Pumps - Portable suction pumps, Stationary suction pumps, Canisters
- Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
- Lymphedema Compression Treatment Items -
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 45D2247482
- Facility Type
- Pharmacy
- Certificate Effective Date
- January 06, 2024
- Certificate Expiration Date
- January 05, 2026
- Laboratory Director
- JONATHAN WAGNER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Mp Southpark Pharmacy Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for MP SOUTHPARK PHARMACY LLC
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1427081447, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 63 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1427081447, enumerated as an "organization" on July 10, 2006.
The provider is located at 29 S CHADB0URNE SAN ANGELO, TX 76903 and the phone number is (325) 655-3146.
Pharmacy with taxonomy code 3336L0003X and a focus in Long Term Care Pharmacy.
The provider might be accepting Accepts: AvMed, Baylor Scott and White Health Plan,. Please consult your insurance carrier or call the provider to verify.
