Mp Southpark Pharmacy Llc
Long Term Care Pharmacy
29 S Chadb0urne, San Angelo
Texas, 76903-5891
325-655-3146 325-658-5891
Mp Southpark Pharmacy Llc is a Long Term Care Pharmacy in San Angelo, Texas. It is located at 29 S Chadb0urne, San Angelo and it's customer support contact number is 325-655-3146. The authorized person of Mp Southpark Pharmacy Llc is Micah Pratt, PHARMD who is Owner of the pharmacy and his contact number is 806-548-0590. Mp Southpark Pharmacy Llc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Mp Southpark Pharmacy Llc is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
Pharmacy Details:
Mp Southpark Pharmacy Llc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Mp Southpark Pharmacy Llc |
| Type: | Long Term Care Pharmacy |
| Location: | 29 S Chadb0urne, San Angelo,
Texas, 76903-5891 |
| Phone: | 325-655-3146 |
| Fax: | 325-658-5891 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Micah Pratt |
| Credentials: | PHARMD |
| Position: | Owner |
| Contact Number: | 806-548-0590 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1427081447 |
| NPI Enumeration Date: | 10 Jul, 2006 |
| NPI Last Update On: | 12 Sep, 2025 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mp Southpark Pharmacy Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Long Term Care Pharmacy | | | Primary | |
| Durable Medical Equipment & Medical Supplies | | | Secondary | |
| Community/Retail Pharmacy | 31522 | Texas | Secondary | |
| Compounding Pharmacy | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 31522 | Other | Texas | Pharmacy License |
Medicare Enrollment:
Mp Southpark Pharmacy Llc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 9739204694 | O20100915000595 | Myers Drug Inc | PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY) |
Products Available:
Mp Southpark Pharmacy Llc has following products available for sale under medicare.
| Products: |
|---|
| • Breast Prostheses & Accessories | • Enteral Equipment And/or Supplies |
| • Enteral Nutrients | • Nebulizer Equipment & Supplies |
| • Oxygen Equipment & Supplies | • Seat Lift Mechanisms |
| • Walkers | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 29 S Chadb0urne,
San Angelo, Texas |
| Zip: | 76903-5891 |
| Phone Number: | 325-655-3146 |
| Fax Number: | 325-658-5891 |
Patients can reach Mp Southpark Pharmacy Llc at
29 S Chadb0urne, San Angelo, Texas or can
call on customer care at 325-655-3146.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.