Burleson Pharmacy LLC
NPI 1700419769ActiveOrganization· Pharmacy· Burleson, TX
Pharmacy in Burleson, Texas, registered in NPPES in February 2020. The authorized official on file is Mahathi Kankanala, PHARM D, Pharmacy Manager. Enrolled in Medicare as part b supplier - mass immunization (roster biller only).
Overview
| NPI | 1700419769 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 18, 2020 |
| Last updated in NPPES | Feb 18, 2020 |
| Certified by provider | Feb 18, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | — | — |
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) |
|---|
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