MEDICARE: ROCKET PHARMACY, INC.

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	33403	OTHER	TX	TEXAS STATE BOARD OF PHARMACY

General Provider Information

NPI Number	:	1649885195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKET PHARMACY, INC.

Provider Business Mailing Address
First Line	:	316 W 12TH ST STE LL050
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-1815
Country	:	US
Telephone Number	:	888-900-7361
Fax Number	:	888-900-7361

Provider Business Practice Location Address
First Line	:	316 W 12TH ST STE LL050
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-1815
Country	:	US
Telephone Number	:	888-900-7361
Fax Number	:	888-900-7361

Authorized Official
Title or Position	:	CEO
Name	:	MICHAEL HEARN
Credential	:
Telephone Number	:	512-983-8186

Provider Enumeration Date	:	09/11/2020
Last Update Date	:	09/11/2020

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Directions to “ROCKET PHARMACY, INC. ” Practice Location

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