Mp Southpark Pharmacy LLC
NPI 1427081447ActiveOrganization· Pharmacy, Long Term Care Pharmacy· San Angelo, TX
Pharmacy, Long Term Care Pharmacy in San Angelo, Texas, registered in NPPES in July 2006. The authorized official on file is Micah Pratt, PHARMD, Owner. Medicare paid $13,065 for services to 121 patients in 2024.
Overview
| NPI | 1427081447 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 10, 2006 |
| Last updated in NPPES | Sep 12, 2025 |
| Certified by provider | Jul 5, 2023 |
Specialties and licenses
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) | Enrolled Part B Supplier - Mass Immunization (Roster Biller Only) (TX) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 121 |
|---|---|
| Services billed | 242 across 5 procedure codes |
| Paid by Medicare | $13,065 |
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