Provider Demographics
NPI:1245591130
Name:PRN PHARMACISTS OF AMERICA, LLC
Entity Type:Organization
Organization Name:PRN PHARMACISTS OF AMERICA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:RIGSBY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:214-699-1334
Mailing Address - Street 1:4105 GREENWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5563
Mailing Address - Country:US
Mailing Address - Phone:214-699-1334
Mailing Address - Fax:866-817-8553
Practice Address - Street 1:4105 GREENWOOD WAY
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-5563
Practice Address - Country:US
Practice Address - Phone:214-699-1334
Practice Address - Fax:866-817-8553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41984183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Multi-Specialty
No183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty