Healthcare Provider Details

I. General information

NPI: 1538144373
Provider Name (Legal Business Name): US-RX-DIRECT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2103 HIGHWAY 16 S
GRAHAM TX
76450-4638
US

IV. Provider business mailing address

2103 HIGHWAY 16 S P O BOX 1109
GRAHAM TX
76450-4638
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 Code333600000X
TaxonomyPharmacy
License Number24206
License Number StateTX

VIII. Authorized Official

Name: MR. JIM W PURYEAR
Title or Position: PRESIDENT
Credential: R PH
Phone: 940-550-5020