DOUGHERTYS LTC PHARMACY LLC
NPI 1578093183
Pharmacy - Long Term Care Pharmacy in Dallas, TX

NPI Status: Active since June 15, 2017

Contact Information

5959 ROYAL LN STE 513
DALLAS, TX
ZIP 75230
Phone: (214) 373-5301
Fax: (214) 373-5333

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  • Organization
  • Pharmacy
  • Long Term Care Pharmacy
  • Accepts Insurance
  • CLIA Number: 45D2024115
  • CLIA Cert. Type: Pharmacy
  • CLIA Exp. Date: 05-10-2026

About DOUGHERTYS LTC PHARMACY LLC

This page provides the complete NPI Profile along with additional information for Doughertys Ltc Pharmacy Llc, a provider established in Dallas, Texas operating as a Pharmacy, focusing in long term care pharmacy . The healthcare provider is registered in the NPI registry with number 1578093183 assigned on June 2017. The practitioner's primary taxonomy code is 3336L0003X with license number 31452 (TX). The provider is registered as an organization and their NPI record was last updated one year ago. The provider's . The authorized official of this NPI record is Andrew Komuves (President&ceo)

NPI
1578093183
Provider Legal Name
DOUGHERTYS LTC PHARMACY LLC
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
5959 ROYAL LN STE 513 DALLAS, TX 75230
Location Phone
(214) 373-5301
Location Fax
(214) 373-5333
Mailing Address
5959 ROYAL LN SUITE 513 DALLAS, TX 75230
Mailing Phone
(214) 373-5301
Mailing Fax
(214) 373-5333
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-15-2017
Last Update Date
09-19-2025
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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
License No.
31452
License State
TX
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)
1333600000XSuppliers

Pharmacy

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • 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

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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ANDREW KOMUVES

Authorized Official Title
PRESIDENT&CEO
Authorized Official Phone
(972) 860-0229

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
351064MEDICAID (05)TX 
2169947OTHER (01)PK

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
45D2024115
Facility Type
Pharmacy
Certificate Effective Date
May 11, 2024
Certificate Expiration Date
May 10, 2026
Laboratory Director
SHAHRUM PAZOKI
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Doughertys Ltc 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.

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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 1578093183, we treat the final digit (3) 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 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).

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.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
8
Unchanged
Pos 5
0
Doubled → 0
Pos 6
9
Unchanged
Pos 7
3
Doubled → 6
Pos 8
1
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
3
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 7 → 14 → 5 0 → 0 3 → 6 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 1 + 4 + 8 + 0 + 9 + 6 + 1 + 1 + 6 + 24 = 67

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1578093183.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1578093183, enumerated as an "organization" on June 15, 2017.

The provider is located at 5959 ROYAL LN STE 513 DALLAS, TX 75230 and the phone number is (214) 373-5301.

Pharmacy with taxonomy code 3336L0003X and a focus in Long Term Care Pharmacy.

The provider might be accepting Accepts: Medica, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.