1649555749 NPI number — RX DIRECT, INC.

Table of content: (NPI 1649555749)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649555749 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:
Provider Other Organization Name Type Code:
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:
1649555749
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 SOUTHPARK CIR STE 400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32819-9057
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-511-5144
Provider Business Mailing Address Fax Number:
877-541-1503

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1311 W SAM HOUSTON PKWY N STE 140
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77043-4015
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:
10/20/2011

Additional Information

Authorized Official

Authorized Official Last Name:
KYMELA
Authorized Official First Name:
RUTH
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACIST IN CHARGE
Authorized Official Telephone Number:
866-839-2035

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: 16088 . This is a "TEXAS STATE BOARD OF PHARMACY" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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