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NPI Code Detail

MEDICARE: FIRSTLINE RX LLC

MEDICARE: FIRSTLINE RX LLC
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
13336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1457017873
Entity Type Code : Organization
Provider Name (Legal Business Name) : FIRSTLINE RX LLC
Provider Business Mailing Address
First Line : 2406 KARAT DR
Second Line : SAN ANTONIO
City : SAN ANTONIO
State : TX
Zip : 78232
Country : US
Telephone Number : 918-808-3089
Fax Number :
Provider Business Practice Location Address
First Line : 2838 N LOOP 1604 E SUITE 108
Second Line : SAN ANTONIO
City : SAN ANTONIO
State : TX
Zip : 78232-1711
Country : US
Telephone Number : 210-481-4269
Fax Number : 210-481-4270
Authorized Official
Title or Position : MANAGER/OWNER
Name : GEORGE AMPOFO
Credential :
Telephone Number : 918-808-3089
Provider Enumeration Date : 11/10/2021
Last Update Date : 02/10/2022

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Directions to “FIRSTLINE RX LLC ” Practice Location

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