CC PHARMACY 3
NPI 1639669005
Pharmacy - Community/Retail Pharmacy in Round Rock, TX

NPI Status: Active since May 11, 2018

Contact Information

3000 JOE DIMAGGIO BLVD STE 57
ROUND ROCK, TX
ZIP 78665
Phone: (737) 202-4101
Fax: (737) 202-4104

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  • Organization
  • Pharmacy
  • Community/Retail Pharmacy
  • CLIA Number: 45D2066965
  • CLIA Cert. Type: Pharmacy
  • CLIA Exp. Date: 10-06-2027

About CC PHARMACY 3

This page provides the complete NPI Profile along with additional information for Cc Pharmacy 3, a provider established in Round Rock, Texas operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1639669005 assigned on May 2018. The practitioner's primary taxonomy code is 3336C0003X with license number 31312 (TX). The provider is registered as an organization and their NPI record was last updated 8 years ago. The provider's is doing business as Cc Pharmacy 3. The authorized official of this NPI record is Warren Deforge (Pharmacist)

NPI
1639669005
Provider Legal Name
CC PHARMACY 3 LLC
Other Organization Name
CC PHARMACY 3
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
3000 JOE DIMAGGIO BLVD STE 57 ROUND ROCK, TX 78665
Location Phone
(737) 202-4101
Location Fax
(737) 202-4104
Mailing Address
3000 JOE DIMAGGIO BLVD SUITE #57 ROUND ROCK, TX 78665
Mailing Phone
(737) 202-4101
Mailing Fax
(737) 202-4104
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-11-2018
Last Update Date
07-19-2018
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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 Community/Retail Pharmacy

Taxonomy Code
3336C0003X
Type
Suppliers
License No.
31312
License State
TX
Taxonomy Description
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.

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:

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

WARREN DEFORGE

Authorized Official Title
PHARMACIST
Authorized Official Phone
(737) 202-4101

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
2177684OTHER (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
45D2066965
Facility Type
Pharmacy
Certificate Effective Date
October 07, 2025
Certificate Expiration Date
October 06, 2027
Laboratory Director
VAN COWAN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Cc Pharmacy 3 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 1639669005, we treat the final digit (5) 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 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

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
6
Unchanged
Pos 3
3
Doubled → 6
Pos 4
9
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
6
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
0
Unchanged
Pos 9
0
Doubled → 0
Check
5
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 3 → 6 6 → 12 → 3 9 → 18 → 9 0 → 0

Step 2: Add all digits plus the NPI constant

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

2 + 6 + 6 + 9 + 1 + 2 + 6 + 1 + 8 + 0 + 0 + 24 = 65

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

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1639669005.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1639669005, enumerated as an "organization" on May 11, 2018.

The provider is located at 3000 JOE DIMAGGIO BLVD STE 57 ROUND ROCK, TX 78665 and the phone number is (737) 202-4101.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

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