1. Home
  2. Directory
  3. Texas
  4. Tyler
  5. Pharmacy
  6. NPI Profile

ROSE CITY PHARMACY LLC
NPI 1780101816
Pharmacy - Community/Retail Pharmacy in Tyler, TX

Active since August 29, 2017
2130 W GRANDE BLVD, TYLER, TX 75703(903) 707-2034(903) 707-2036 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Jun 16, 2018, Aug 29, 2017 (3 updates tracked since 2017).

About Rose City Pharmacy Llc NPPES

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

ROSE CITY PHARMACY LLC (NPI 1780101816) is a healthcare organization registered as a community/retail pharmacy in Tyler, Texas and active in the NPI registry since August 2017. The organization lists Wilson Lee Krezdorn, Owner, as its authorized official.

NPPES Registry Identity

NPI1780101816
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameROSE CITY PHARMACY LLC
Location Address2130 W GRANDE BLVDTyler, TX 75703-0563
Mailing Address2130 W Grande BlvdTyler, TX 75703-0563 · (903) 707-2034 · Fax (903) 707-2036
Phone(903) 707-2034
Fax(903) 707-2036
Organization SubpartNo
Authorized OfficialWilson Lee KrezdornOwner · (903) 707-2034
Enumeration DateAugust 29, 2017
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
✔ NPI 1780101816 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 · 31557
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 31557 (TX)
2130 W GRANDE BLVD, Tyler, TX 75703
Open in Google Maps ↗

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 Arizona Complete Health and more.Insurance ›

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
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.
81 services81 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
78 services78 patients

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.

DR. WILSON LEE KREZDORN PHARM.D.
Pharmacist
2130 W GRANDE BLVD
TYLER, TX 75703
Smith County (903) 707-2034
ROSE CITY PHARMACY LLC
Pharmacy (Long Term Care Pharmacy)
2130 W GRANDE BLVD
TYLER, TX 75703
Smith County (903) 707-2034

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 Rose City Pharmacy LLC's NPI number?

The NPI number for Rose City Pharmacy LLC is 1780101816. It was assigned to this organization in the NPPES registry on August 29, 2017.

Where is Rose City Pharmacy LLC located?

Rose City Pharmacy LLC is located at 2130 W Grande Blvd, Tyler, TX 75703. The listed phone number is (903) 707-2034.

What is Rose City Pharmacy LLC's specialty?

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

What insurance does Rose City Pharmacy LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 52 other insurers list Rose City Pharmacy LLC 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 Rose City Pharmacy LLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.