Provider Demographics
NPI:1306179981
Name:PRESCRIPTION HEALTH RESOURCES, LLC
Entity Type:Organization
Organization Name:PRESCRIPTION HEALTH RESOURCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-590-9599
Mailing Address - Street 1:7345 AIRPORT FWY
Mailing Address - Street 2:
Mailing Address - City:RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76118-6902
Mailing Address - Country:US
Mailing Address - Phone:817-590-9599
Mailing Address - Fax:817-590-9499
Practice Address - Street 1:7345 AIRPORT FWY
Practice Address - Street 2:
Practice Address - City:RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76118-6902
Practice Address - Country:US
Practice Address - Phone:817-590-9599
Practice Address - Fax:817-590-9499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27102251F00000X, 3336C0003X, 3336C0004X, 3336H0001X, 3336L0003X
TX1002125332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX27102OtherSTATE PHARMACY LICENSE
TX5901043OtherNCPDP
TX6391890001Medicare NSC