MEDICARE: DISCOUNT 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
1	3336L0003X	Long Term Care Pharmacy
2	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1740950039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DISCOUNT RX LLC

Provider Business Mailing Address
First Line	:	12345 JONES RD STE 160
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-4958
Country	:	US
Telephone Number	:	832-912-4458
Fax Number	:	832-912-4486

Provider Business Practice Location Address
First Line	:	12345 JONES RD STE 160
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-4958
Country	:	US
Telephone Number	:	832-912-4458
Fax Number	:	832-912-4486

Authorized Official
Title or Position	:	OWNER
Name	:	CONTINA EVANS
Credential	:
Telephone Number	:	901-650-2832

Provider Enumeration Date	:	09/17/2021
Last Update Date	:	02/08/2023

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Directions to “DISCOUNT RX LLC ” Practice Location

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