Provider Demographics
NPI:1144565300
Name:RUSHMED PHARMACY P.L.L.C
Entity Type:Organization
Organization Name:RUSHMED PHARMACY P.L.L.C
Other - Org Name:RUSHMED PHARMACY P.L.L.C
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LASHONDA
Authorized Official - Middle Name:CHERI
Authorized Official - Last Name:RUSH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:281-451-9447
Mailing Address - Street 1:4430 W. FUQUA STREET, SUITE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77045
Mailing Address - Country:US
Mailing Address - Phone:832-582-8542
Mailing Address - Fax:832-538-1906
Practice Address - Street 1:4430 W. FUQUA STREET, SUITE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77045
Practice Address - Country:US
Practice Address - Phone:832-582-8542
Practice Address - Fax:832-538-1906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-29
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX283253336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5907641OtherNCPDP PROVIDER IDENTIFICATION NUMBER