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DERAMED SPECIALTY PHARMACY
NPI 1801414933
Pharmacy - Long Term Care Pharmacy in Mansfield, TX

Active since July 06, 2020CLIA 45D2161083 · Waiver
1001 MATLOCK RD STE 105, MANSFIELD, TX 76063(817) 592-3636 Get Directions Write a Review

NPPES record last updated: May 3, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 3, 2024, Nov 21, 2022, Sep 20, 2021 and 2 more (5 updates tracked since 2020).

About Deramed Specialty Pharmacy NPPES

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

DERAMED SPECIALTY PHARMACY (NPI 1801414933) is a healthcare organization registered as a long term care pharmacy in Mansfield, Texas and active in the NPI registry since July 2020. The organization holds a CLIA Waiver certificate valid through January 24, 2027 and lists Aderonke Efunogbon, Director, as its authorized official.

NPPES Registry Identity

NPI1801414933
Entity TypeOrganization
Primary Taxonomy3336L0003X
Legal Business NameDERAMED LTC PHARMACY
Location Address1001 MATLOCK RD STE 105Mansfield, TX 76063-3443
Mailing Address1001 Matlock Rd Ste 105Mansfield, TX 76063-3443 · (817) 592-3636
Phone(817) 592-3636
Organization SubpartYesParent: Derhann Co. Llc
Authorized OfficialAderonke EfunogbonDirector · (817) 592-3636
Enumeration DateJuly 6, 2020
Last NPPES UpdateMay 3, 20245 updates tracked since enumeration
NPPES CertifiedMay 3, 2024
✔ NPI 1801414933 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Long Term Care PharmacySuppliers
Taxonomy Code3336L0003X
Definition
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.
Also ListedPharmacy · Specialty PharmacyTaxonomy 3336S0011X
1001 MATLOCK RD STE 105, Mansfield, TX 76063
Open in Google Maps ↗

Other Names 1

Doing Business AsDeramed Specialty Pharmacy

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc. and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

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 Waiver 45D2161083

Deramed Specialty Pharmacy · Mansfield, TX
Active · expires Jan 24, 2027
CLIA Number45D2161083
Laboratory TypePharmacy
Certificate Effective DateJanuary 25, 2025
Certificate Expiration DateJanuary 24, 2027
Laboratory DirectorAderonke A. Efunogbon
Laboratory Phone(817) 381-3861
Laboratory LocationDeramed Specialty Pharmacy1001 Matlock Rd Suite 105, Mansfield, TX 76063
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

SPRINGWAY HEALTHCARE LLC
Assisted Living Facility
1001 MATLOCK RD STE 105
MANSFIELD, TX 76063
Tarrant County (817) 903-7837
DERHANN CO LLC
Pharmacy (Specialty Pharmacy)
1001 MATLOCK RD STE 105
MANSFIELD, TX 76063
Tarrant County (817) 592-3636
ADERONKE EFUNOGBON
Pharmacist
1001 MATLOCK RD STE 105
MANSFIELD, TX 76063
Tarrant County (817) 592-3636

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 Deramed Ltc Pharmacy's NPI number?

The NPI number for Deramed Ltc Pharmacy is 1801414933. It was assigned to this organization in the NPPES registry on July 6, 2020. The provider is doing business as Deramed Specialty Pharmacy.

Where is Deramed Ltc Pharmacy located?

Deramed Ltc Pharmacy is located at 1001 Matlock Rd Ste 105, Mansfield, TX 76063. The listed phone number is (817) 592-3636.

What is Deramed Ltc Pharmacy's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Long Term Care Pharmacy, with taxonomy code 3336L0003X.

Does Deramed Ltc Pharmacy hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2161083) is associated with this NPI, valid through January 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Deramed Ltc Pharmacy accept?

Health plans from Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc., Arkansas Blue Cross and Blue Shield and Avera Health Plans and 28 other insurers list Deramed Ltc Pharmacy 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 Deramed Ltc Pharmacy was last updated on May 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.