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Southland Legend Pharmacy

Community/Retail Pharmacy in Tyler, TX · enumerated 2006 · authorized official Doug Benedetti, Pic.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1225142219

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Registry record

Entity type Organization (Type 2)
Legal business name Southland Legend Pharmacy
Practice address 5201 S Broadway Ave, Ste 100, Tyler, TX, 75703
Phone (903) 534-8218
Fax (903) 534-2897
Enumeration date Aug 18, 2006
Last updated in NPPES Sep 11, 2025

Taxonomy & classification

333600000X Pharmacy Suppliers · License 17039 (TX) Secondary
3336C0003X Community/Retail Pharmacy Suppliers Primary

Authorized official

Name Doug Benedetti
Title Pic
Phone (903) 534-8218

Other identifiers

Identifier Type State Issuer
144423 Medicaid TX -
4572093 Other - OTHER ID NUMBER-COMMERCIAL NUMBER

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Southland Legend Pharmacy?
NPPES lists Doug Benedetti (Pic) as the authorized official for this organization.
What is the NPI number for Southland Legend Pharmacy?
The NPI for Southland Legend Pharmacy is 1225142219, a Type 2 (organization) record in the CMS NPPES registry.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-09-11.