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General NPI Number Information
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NPI Number | 1447744545
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Entity Type | Organization
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Legal Business Name | RISING STAR GROUP LLC
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 01/22/2019
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Provider Practice Location Address
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Address Line | 279 W MAIN ST STE 128
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City | FRISCO
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State | TX
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Zip | 75034
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Country | US
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Telephone | 469-731-1204
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2248
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City | COPPELL
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State | TX
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Zip | 75019-8248
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Country | US
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Telephone | 469-666-4633
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | TRI NHO NGUYEN
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Credential |
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Telephone | 469-731-1204
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 32119
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License Number State | TX
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