SAN DIEGO PHARMACY
NPI 1942772272
Pharmacy - Community/Retail Pharmacy in San Diego, TX

Active since December 27, 2018CLIA 45D2196852 · Waiver
508 E GRAVIS ST, SAN DIEGO, TX 78384(361) 209-8322(361) 209-5022 Get Directions Write a Review

NPPES record last updated: December 29, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 15, 2023, Feb 9, 2020, Dec 27, 2018 (3 updates tracked since 2018).

About San Diego Pharmacy NPPES

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

SAN DIEGO PHARMACY (NPI 1942772272) is a healthcare organization registered as a community/retail pharmacy in San Diego, Texas and active in the NPI registry since December 2018. The organization holds a CLIA Waiver certificate valid through October 19, 2026 and lists Nandana Kavuri, Officer, as its authorized official.

NPPES Registry Identity

NPI1942772272
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameRISING STAR HOLDINGS LLC
Location Address508 E GRAVIS STSan Diego, TX 78384-2708
Mailing AddressPo Box 1488Coppell, TX 75019-1488 · (361) 209-8322 · Fax (361) 209-5022
Fax(361) 209-5022
Organization SubpartNo
Authorized OfficialNandana KavuriOfficer · (214) 620-7220
Enumeration DateDecember 27, 2018
Last NPPES UpdateDecember 29, 20233 updates tracked since enumeration
NPPES CertifiedDecember 29, 2023
NPI 1942772272 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
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
508 E GRAVIS ST, San Diego, TX 78384

Other Names 1

Doing Business AsSan Diego Pharmacy

Accepted 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 45D2196852

San Diego Pharmacy · San Diego, TX
Active · expires Oct 19, 2026
CLIA Number45D2196852
Laboratory TypePharmacy
Certificate Effective DateOctober 20, 2024
Certificate Expiration DateOctober 19, 2026
Laboratory DirectorKavuri Nandana
Laboratory Phone(361) 209-8322
Laboratory LocationSan Diego Pharmacy508 E Gravis Street, San Diego, TX 78384
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 6

Medicare supplier enrollment and the product categories San Diego Pharmacy carries, from the Medicare DMEPOS supplier directory.

San Diego Pharmacy

DMEPOS supplier · San Diego, TXOperated by Rising Star Holdings LLC

Does not accept Medicare assignment

San Diego Pharmacy has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)23282773
Medicare Participant SinceFebruary 28, 2019
Supplier Location508 E Gravis StSan Diego, TX 78384
Supplier Specialties
Certified Other Pharmacy

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

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 Rising Star Holdings LLC's NPI number?

The NPI number for Rising Star Holdings LLC is 1942772272. It was assigned to this organization in the NPPES registry on December 27, 2018. The provider is doing business as San Diego Pharmacy.

Where is Rising Star Holdings LLC located?

Rising Star Holdings LLC is located at 508 E Gravis St, San Diego, TX 78384. The listed phone number is (361) 209-8322.

What is Rising Star Holdings LLC's specialty?

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

Does Rising Star Holdings LLC accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, San Diego Pharmacy does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Rising Star Holdings LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2196852) is associated with this NPI, valid through October 19, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Rising Star Holdings 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 55 other insurers list Rising Star Holdings 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 Rising Star Holdings LLC was last updated on December 29, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.