MEDICARE: LOTUS RX INC

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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1336776780
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOTUS RX INC

Provider Business Mailing Address
First Line	:	2227 LUCKENBACH LN
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-3852
Country	:	US
Telephone Number	:	972-924-0404
Fax Number	:	972-924-0809

Provider Business Practice Location Address
First Line	:	105 N SHANNON ST
Second Line	:
City	:	KAUFMAN
State	:	TX
Zip	:	75142-1836
Country	:	US
Telephone Number	:	972-924-0404
Fax Number	:

Authorized Official
Title or Position	:	PHARMACY MANAGER
Name	:	SWAPNA KONDU
Credential	:
Telephone Number	:	972-924-0404

Provider Enumeration Date	:	03/25/2020
Last Update Date	:	03/25/2020

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Directions to “LOTUS RX INC ” Practice Location

Language	Start Address	Practice Location

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