Provider Demographics
NPI:1043664865
Name:RPR HEALTHCARE INC
Entity Type:Organization
Organization Name:RPR HEALTHCARE INC
Other - Org Name:REDBIRD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJPARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-982-2970
Mailing Address - Street 1:1251 E RED BIRD LN
Mailing Address - Street 2:STE 120
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75241-2008
Mailing Address - Country:US
Mailing Address - Phone:972-982-2970
Mailing Address - Fax:972-982-2969
Practice Address - Street 1:1251 E RED BIRD LN STE 120
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75241-2008
Practice Address - Country:US
Practice Address - Phone:972-982-2970
Practice Address - Fax:972-982-2969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-18
Last Update Date:2016-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX307683336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149404Medicaid
2159679OtherPK