OrganizationActive
Rose City Pharmacy LLC
NPI 1194317289 · Long Term Care Pharmacy · Tyler, TX
Rose City Pharmacy LLC is a Long Term Care Pharmacy organization in Tyler, TX (NPI 1194317289).
Provider details
- NPI number
- 1194317289
- Entity type
- Organization
- Primary specialty
- Long Term Care PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Wilson Krezdorn, President/Pharmacist(903) 707-2034
Specialties & taxonomies
Suppliers
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2130 W Grande Blvd
Tyler, TX 75703-0563
Phone: (903) 707-2034
Fax: (903) 707-2036
Street-level locationGet directions
Mailing address
2130 W Grande Blvd
Tyler, TX 75703-0563
Registry dates
- Enumerated
- 2021-02-09
- Last updated
- 2021-04-16
- Certified
- 2021-04-16
Frequently asked questions
- What is Rose City Pharmacy LLC's NPI number?
- Rose City Pharmacy LLC's National Provider Identifier (NPI) is 1194317289, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Rose City Pharmacy LLC?
- Rose City Pharmacy LLC is classified in the NPPES registry as Long Term Care Pharmacy (Suppliers).
- Where is Rose City Pharmacy LLC located?
- Rose City Pharmacy LLC's practice location on file with NPPES is 2130 W Grande Blvd, Tyler, TX 75703-0563.
- What is Rose City Pharmacy LLC's phone number?
- The practice phone number listed in the NPPES registry for Rose City Pharmacy LLC is (903) 707-2034.
- Who is the authorized official for Rose City Pharmacy LLC?
- The authorized official listed on Rose City Pharmacy LLC's NPPES record is Wilson Krezdorn, President/Pharmacist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Rose City Pharmacy LLC's NPI active?
- Yes — Rose City Pharmacy LLC's NPI (1194317289) is active in the NPPES registry as of the last update on 2021-04-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.