Provider Demographics
NPI:1043221633
Name:EXPRESS RX LLC
Entity Type:Organization
Organization Name:EXPRESS RX LLC
Other - Org Name:CAREPHARM PHARMACY LTC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JP
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTEVERDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-223-5229
Mailing Address - Street 1:3535 BRIARPARK DR
Mailing Address - Street 2:STE 110
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-5245
Mailing Address - Country:US
Mailing Address - Phone:281-619-2079
Mailing Address - Fax:281-619-2085
Practice Address - Street 1:3535 BRIARPARK DR
Practice Address - Street 2:STE 110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-5245
Practice Address - Country:US
Practice Address - Phone:281-619-2079
Practice Address - Fax:281-619-2085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336S0011X, 3336C0004X
TX241333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200043950BMedicaid
2099044OtherPK
TX200043950BMedicaid