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General NPI Number Information
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NPI Number | 1518580422
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Entity Type | Organization
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Legal Business Name | MEDSTORK RX, LLC
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Dates
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Enumeration Date | 05/26/2020
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Last Update Date | 06/01/2020
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Provider Practice Location Address
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Address Line | 1413 E INTERSTATE 30 STE 6
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City | GARLAND
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State | TX
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Zip | 75043-4784
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Country | US
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Telephone | 888-700-5702
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Fax |
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Provider Business Mailing Address
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Address Line | 156 FALCON POINT DR
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City | ROCKWALL
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State | TX
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Zip | 75032-8652
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Country | US
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Telephone | 972-689-9442
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JESSICA RIGGS
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Credential |
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Telephone | 972-689-9442
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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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