1356658470 NPI number — THE RITE PHARMACY INC

Table of content: DR. PAMELA ANN OLOUGHLIN PHARMACIST (NPI 1205816428)

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:
Provider Other Organization Name Type Code:
6
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: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • 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" .

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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