1568645273 NPI number — RX S & P INC

Table of content: (NPI 1568645273)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568645273 NPI number — RX S & P INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RX S & P 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:
ST ROSE 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:
1568645273
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3749
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MISSION
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78573-0064
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
909 BUSINESS PARK DR
Provider Second Line Business Practice Location Address:
STE 2
Provider Business Practice Location Address City Name:
MISSION
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78572-6052
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-424-0057
Provider Business Practice Location Address Fax Number:
956-424-0241
Provider Enumeration Date:
12/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SOLIS
Authorized Official First Name:
NORA
Authorized Official Middle Name:
Authorized Official Title or Position:
PIC
Authorized Official Telephone Number:
956-369-6672

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  25824 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4547088 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".




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