1225136575 NPI number — RX DIRECT, INC.

Table of content: (NPI 1225136575)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225136575 NPI number — RX DIRECT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RX DIRECT, 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:
HOMESCRIPTS
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:
1225136575
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8427 SOUTH PARK CIRCLE ATTN: LICENSING
Provider Second Line Business Mailing Address:
SUITE 400
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32819
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
855-422-2742
Provider Business Mailing Address Fax Number:
877-617-0830

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1311 W. SAM HOUSTON PKWY N.
Provider Second Line Business Practice Location Address:
SUITE 140
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-839-2035
Provider Business Practice Location Address Fax Number:
866-827-4962
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JENSEN
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
800-511-5144

Provider Taxonomy Codes

  • Taxonomy code: 3336L0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 145474 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4590724 . This is a "N.A.B.P." identifier . This identifiers is of the category "OTHER".




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