MEDICARE: SIMPLY RX LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1437844305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIMPLY RX LLC

Provider Business Mailing Address
First Line	:	2103 N RICHMOND RD
Second Line	:
City	:	WHARTON
State	:	TX
Zip	:	77488-2720
Country	:	US
Telephone Number	:	979-531-3084
Fax Number	:

Provider Business Practice Location Address
First Line	:	2103 N RICHMOND RD
Second Line	:
City	:	WHARTON
State	:	TX
Zip	:	77488-2720
Country	:	US
Telephone Number	:	979-531-3084
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KAISHA GILLESPIE
Credential	:
Telephone Number	:	832-836-1278

Provider Enumeration Date	:	04/06/2023
Last Update Date	:	04/06/2023

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Directions to “SIMPLY RX LLC ” Practice Location

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