OrganizationActive
Red River Pharmacy Long Term Care, LLC
NPI 1447500590 · Long Term Care Pharmacy · Tyler, TX
Red River Pharmacy Long Term Care, LLC is a Long Term Care Pharmacy organization in Tyler, TX (NPI 1447500590).
Provider details
- NPI number
- 1447500590
- Entity type
- Organization
- Primary specialty
- Long Term Care PharmacySuppliers
- Organization subpart
- No
- Authorized official
- David Boudreaux, President/Owner(903) 792-1721
- License
- 28138 (TX)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 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
4801 Troup Hwy
Suite 402
Tyler, TX 75703-2356
Phone: (903) 617-6885
Fax: (844) 308-8629
Street-level locationGet directions
Mailing address
1550 Moores Ln Ste a
Texarkana, TX 75503-4657
Other names (DBA / former)
- Doing business as
- Red River Ltc of Tyler
- Doing business as
- Red River Ltc of Tyler
Registry dates
- Enumerated
- 2012-09-17
- Last updated
- 2022-05-31
- Certified
- 2022-05-31
Frequently asked questions
- What is Red River Pharmacy Long Term Care, LLC's NPI number?
- Red River Pharmacy Long Term Care, LLC's National Provider Identifier (NPI) is 1447500590, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Red River Pharmacy Long Term Care, LLC?
- Red River Pharmacy Long Term Care, LLC is classified in the NPPES registry as Long Term Care Pharmacy (Suppliers).
- Where is Red River Pharmacy Long Term Care, LLC located?
- Red River Pharmacy Long Term Care, LLC's practice location on file with NPPES is 4801 Troup Hwy, Tyler, TX 75703-2356.
- What is Red River Pharmacy Long Term Care, LLC's phone number?
- The practice phone number listed in the NPPES registry for Red River Pharmacy Long Term Care, LLC is (903) 617-6885.
- Who is the authorized official for Red River Pharmacy Long Term Care, LLC?
- The authorized official listed on Red River Pharmacy Long Term Care, LLC's NPPES record is David Boudreaux, President/Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Red River Pharmacy Long Term Care, LLC's NPI active?
- Yes — Red River Pharmacy Long Term Care, LLC's NPI (1447500590) is active in the NPPES registry as of the last update on 2022-05-31.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.