MEDICARE: RWO LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	12262	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4528785	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1265546253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RWO LP

Provider Business Mailing Address
First Line	:	2222 W 24TH ST
Second Line	:
City	:	PLAINVIEW
State	:	TX
Zip	:	79072-1802
Country	:	US
Telephone Number	:	806-293-4151
Fax Number	:	806-293-5143

Provider Business Practice Location Address
First Line	:	2222 W 24TH ST
Second Line	:
City	:	PLAINVIEW
State	:	TX
Zip	:	79072-1802
Country	:	US
Telephone Number	:	806-293-4151
Fax Number	:	806-293-5143

Authorized Official
Title or Position	:	PIC
Name	:	MARCELINO GODINO
Credential	:
Telephone Number	:	806-293-4151

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	06/30/2010

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Directions to “RWO LP ” Practice Location

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