COMMUNITY PHARMACY – Community/Retail Pharmacy, NPI 1952415945

COMMUNITY PHARMACY is a healthcare provider. based in San angelo, Texas. specializing in Community/Retail Pharmacy. The organization holds a License No. 13817 (TX). The NPI Number for COMMUNITY PHARMACY is 1952415945

Main info

Organization
Name
COMMUNITY PHARMACY
NPI
1952415945
Phone
(325) 949-4577
Address
3520 KNICKERBOCKER RD STE A
Authorized Official
MARTY DANIEL OWNER/PARTNER RPH
Enumeration Date
18 August 2006
Last Update Date
20 February 2017
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for COMMUNITY PHARMACY

  • 3520 KNICKERBOCKER RD STE A

    SAN ANGELO, TX 769047601

    Phone: (325) 949-4577

    Fax: (325) 224-0997

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-02-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2026-03-31 (73 days ago).

Enrollment records

1

Earliest due date

2026-03-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20210202002270OMass Immunization (Roster Biller Only)TX2026-03-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G0008Administration of influenza virus vaccine118118$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage116116$0
90480Admn sarscov2 vacc 1 dose5858$0
91322Sarscov2 vac 50 mcg/0.5ml im4848$0
View full utilization report →

Insurance plans in this area (ZIP 76904)

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Reviews

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Frequently asked questions

How do I look up COMMUNITY PHARMACY by NPI?
Use NPI 1952415945 when you need to reference COMMUNITY PHARMACY in forms, claims, or directories.
Is COMMUNITY PHARMACY currently active in the NPI registry?
CMS-published data lists COMMUNITY PHARMACY as an active registrant.
What kind of provider is COMMUNITY PHARMACY?
The page reflects Community/Retail Pharmacy for COMMUNITY PHARMACY. Clinical services aligned with this taxonomy classification.
Where is COMMUNITY PHARMACY's primary listing?
We display San Angelo, Texas because that is what the record indicates for COMMUNITY PHARMACY.
Is COMMUNITY PHARMACY a real provider?
This page reflects official NPPES data for NPI 1952415945. Always confirm identity and privileges with the practice and licensing boards.

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