Healthcare Provider Details

I. General information

NPI: 1629199161
Provider Name (Legal Business Name): PREFERRED RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 10/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 CORPORATE DR E
ARLINGTON TX
76006-6105
US

IV. Provider business mailing address

1221 CORPORATE DR E
ARLINGTON TX
76006-6105
US

V. Phone/Fax

Practice location:
  • Phone: 817-385-4707
  • Fax: 817-385-4710
Mailing address:
  • Phone: 817-385-4707
  • Fax: 817-385-4710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number25230
License Number StateTX

VIII. Authorized Official

Name: CARY ROSSEL
Title or Position: OFFICER
Credential:
Phone: 214-888-8099