Provider Demographics
NPI:1255465779
Name:EPICARE PHARMACY LLC
Entity Type:Organization
Organization Name:EPICARE PHARMACY LLC
Other - Org Name:MED RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-695-5000
Mailing Address - Street 1:4000 FULTON ST STE C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77009-4796
Mailing Address - Country:US
Mailing Address - Phone:713-695-5000
Mailing Address - Fax:713-697-8044
Practice Address - Street 1:4000 FULTON ST STE C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-4796
Practice Address - Country:US
Practice Address - Phone:713-695-5000
Practice Address - Fax:713-697-8044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX241563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148143Medicaid
2097606OtherPK