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General NPI Number Information
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NPI Number | 1538144373
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Entity Type | Organization
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Legal Business Name | US-RX-DIRECT, LLC
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2103 HIGHWAY 16 S
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City | GRAHAM
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State | TX
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Zip | 76450-4638
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Country | US
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Telephone | 940-549-0880
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Fax | 866-549-0392
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Provider Business Mailing Address
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Address Line | 2103 HIGHWAY 16 S P O BOX 1109
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City | GRAHAM
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State | TX
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Zip | 76450-4638
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Country | US
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Telephone | 940-549-0880
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Fax | 866-549-0392
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JIM W PURYEAR
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Credential | R PH
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Telephone | 940-550-5020
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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 | 24206
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License Number State | TX
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