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General NPI Number Information
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NPI Number | 1154815256
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Entity Type | Organization
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Legal Business Name | SURE-RX PHARMACY, LLC
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 816 FRANKLIN ST STE A
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City | ANTHONY
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State | TX
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Zip | 79821-7185
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Country | US
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Telephone | 915-886-7222
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Fax | 915-886-7226
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Provider Business Mailing Address
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Address Line | 816 FRANKLIN ST STE A
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City | ANTHONY
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State | TX
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Zip | 79821-7185
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Country | US
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Telephone | 915-886-7222
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Fax | 915-886-7226
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Authorized Official
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Title or Position | OWNER
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Name | DR. JONATHAN USIHO UGEGE
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Credential | PHARM.D
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Telephone | 915-886-7222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 32120
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License Number State | TX
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