OrganizationActive
Southland Legend Pharmacy
NPI 1225142219 · Community/Retail Pharmacy · Tyler, TX
Southland Legend Pharmacy is a Community/Retail Pharmacy organization in Tyler, TX (NPI 1225142219).
Provider details
- NPI number
- 1225142219
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Doug Benedetti, Pic(903) 534-8218
- License
- 17039 (TX)
Specialties & taxonomies
Suppliers
Suppliers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
5201 S Broadway Ave
Ste 100
Tyler, TX 75703-3748
Phone: (903) 534-8218
Fax: (903) 534-2897
Street-level locationGet directions
Mailing address
5201 S Broadway Ave
Tyler, TX 75703-3748
Registry dates
- Enumerated
- 2006-08-18
- Last updated
- 2025-09-11
Frequently asked questions
- What is Southland Legend Pharmacy's NPI number?
- Southland Legend Pharmacy's National Provider Identifier (NPI) is 1225142219, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southland Legend Pharmacy?
- Southland Legend Pharmacy is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Southland Legend Pharmacy located?
- Southland Legend Pharmacy's practice location on file with NPPES is 5201 S Broadway Ave, Tyler, TX 75703-3748.
- What is Southland Legend Pharmacy's phone number?
- The practice phone number listed in the NPPES registry for Southland Legend Pharmacy is (903) 534-8218.
- Who is the authorized official for Southland Legend Pharmacy?
- The authorized official listed on Southland Legend Pharmacy's NPPES record is Doug Benedetti, Pic. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southland Legend Pharmacy's NPI active?
- Yes — Southland Legend Pharmacy's NPI (1225142219) is active in the NPPES registry as of the last update on 2025-09-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.