Provider Demographics
NPI:1225424542
Name:RSVP HEALTHCARE ALLIANCE, LLC
Entity Type:Organization
Organization Name:RSVP HEALTHCARE ALLIANCE, LLC
Other - Org Name:MANOR PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROWDY
Authorized Official - Middle Name:
Authorized Official - Last Name:STOVALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-642-8000
Mailing Address - Street 1:14008 SHADOW GLEN BLVD
Mailing Address - Street 2:STE 102
Mailing Address - City:MANOR
Mailing Address - State:TX
Mailing Address - Zip Code:78653
Mailing Address - Country:US
Mailing Address - Phone:512-642-8000
Mailing Address - Fax:512-642-8001
Practice Address - Street 1:14008 SHADOW GLEN BLVD
Practice Address - Street 2:STE 102
Practice Address - City:MANOR
Practice Address - State:TX
Practice Address - Zip Code:78653
Practice Address - Country:US
Practice Address - Phone:512-642-8000
Practice Address - Fax:512-642-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-14
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148451Medicaid