Healthcare Provider Details

I. General information

NPI: 1679797864
Provider Name (Legal Business Name): US-RX-DIRECT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 BRAZOS ST
GRAHAM TX
76450-4020
US

IV. Provider business mailing address

1309 BRAZOS ST P O BOX 1109
GRAHAM TX
76450-4020
US

V. Phone/Fax

Practice location:
  • Phone: 940-549-0880
  • Fax: 866-549-0392
Mailing address:
  • Phone: 940-549-0880
  • Fax: 866-549-0392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number State

VIII. Authorized Official

Name: MR. JIM W PURYEAR
Title or Position: PRESIDENT
Credential: R PH
Phone: 940-549-0880