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General NPI Number Information
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NPI Number | 1467822981
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Entity Type | Organization
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Legal Business Name | RX MART LLC
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Dates
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Enumeration Date | 09/26/2015
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 10995 PLANO RD STE 101
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City | DALLAS
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State | TX
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Zip | 75238-5321
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Country | US
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Telephone | 972-525-2226
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Fax | 972-270-7306
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Provider Business Mailing Address
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Address Line | 1785 NONCONNAH BLVD SUITE 107
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City | MEMPHIS
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State | TN
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Zip | 38132-2104
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Country | US
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Telephone | 901-730-7769
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Fax | 888-684-0242
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Authorized Official
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Title or Position | CEO
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Name | JOHN PEREIRA
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Credential |
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Telephone | 321-325-6047
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 30332
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License Number State | TX
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