Rose City Pharmacy LLC
NPI 1194317289ActiveOrganization· Pharmacy, Long Term Care Pharmacy· Tyler, TX
Pharmacy, Long Term Care Pharmacy in Tyler, Texas, registered in NPPES in February 2021. The authorized official on file is Wilson L. Krezdorn, PHARMD, President/Pharmacist.
Overview
| NPI | 1194317289 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 9, 2021 |
| Last updated in NPPES | Apr 16, 2021 |
| Certified by provider | Apr 16, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy, Long Term Care Pharmacy Primary | 3336L0003X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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