Healthcare Provider Details

I. General information

NPI: 1417651043
Provider Name (Legal Business Name): APERTURE RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9850 KENT ST STE 200
ELK GROVE CA
95624-9599
US

IV. Provider business mailing address

PO BOX 661307
DALLAS TX
75266-1307
US

V. Phone/Fax

Practice location:
  • Phone: 614-647-5115
  • Fax:
Mailing address:
  • Phone: 380-235-6456
  • Fax: 380-276-6091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MELODY JOY
Title or Position: VP OF PAYER RELATIONS
Credential:
Phone: 203-520-8125