Provider Demographics
NPI:1093018467
Name:ROSE PHARMACY, LLC
Entity Type:Organization
Organization Name:ROSE PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSELINDA
Authorized Official - Middle Name:OBIAGELI
Authorized Official - Last Name:OKEKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-952-9568
Mailing Address - Street 1:5610 W RIVER PARK DR STE B
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-7903
Mailing Address - Country:US
Mailing Address - Phone:713-952-9568
Mailing Address - Fax:713-952-9586
Practice Address - Street 1:5610 W RIVER PARK DR STE B
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-7903
Practice Address - Country:US
Practice Address - Phone:713-952-9568
Practice Address - Fax:713-952-9586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27257305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service