Provider Demographics
NPI:1275969743
Name:RAWLS RX, LLC
Entity Type:Organization
Organization Name:RAWLS RX, LLC
Other - Org Name:RICHARD'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-584-7772
Mailing Address - Street 1:1112 E GRIFFIN PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-2408
Mailing Address - Country:US
Mailing Address - Phone:956-581-4200
Mailing Address - Fax:956-581-4204
Practice Address - Street 1:1112 E GRIFFIN PKWY STE B
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-2409
Practice Address - Country:US
Practice Address - Phone:956-581-4200
Practice Address - Fax:956-581-4204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X
TX287793336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2142063OtherPK