1356658470 NPI number — THE RITE PHARMACY INC

Table of content: (NPI 1356658470)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356658470 NPI number — THE RITE PHARMACY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE RITE PHARMACY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THE RITE PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356658470
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/02/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2225 WILLIAMS TRACE BLVD STE 109
Provider Second Line Business Mailing Address:
STE 109
Provider Business Mailing Address City Name:
SUGAR LAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77478-4440
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-532-0806
Provider Business Mailing Address Fax Number:
832-532-0832

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2225 WILLIAMS TRACE BLVD STE 109
Provider Second Line Business Practice Location Address:
STE 109
Provider Business Practice Location Address City Name:
SUGAR LAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77478-4440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-532-0806
Provider Business Practice Location Address Fax Number:
832-532-0832
Provider Enumeration Date:
09/10/2010

Additional Information

Authorized Official

Authorized Official Last Name:
OZIGBOH
Authorized Official First Name:
QUEEN
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACIST-IN-CHARGE
Authorized Official Telephone Number:
832-532-0806

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  27019 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2126566 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 146246 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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