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General NPI Number Information
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NPI Number | 1225534423
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Entity Type | Organization
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Legal Business Name | POPULAR RX LLC
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Dates
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Enumeration Date | 04/05/2018
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 1118 S HIGHWAY 281 BUSINESS
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City | FALFURRIAS
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State | TX
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Zip | 78355
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Country | US
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Telephone | 361-323-3784
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Fax | 361-323-0024
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Provider Business Mailing Address
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Address Line | 1118 S HIGHWAY 281 BUSINESS
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City | FALFURRIAS
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State | TX
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Zip | 78355
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Country | US
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Telephone | 361-323-3784
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Fax | 361-323-0024
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Authorized Official
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Title or Position | OWNER
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Name | ANIL GOTTIMUKKALA
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Credential | RPH
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Telephone | 973-885-0060
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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 | 32058
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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