Provider Demographics
NPI:1346759651
Name:15RX PHARMACY-2 LP
Entity Type:Organization
Organization Name:15RX PHARMACY-2 LP
Other - Org Name:15RX PHARMACY-3
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DHIRAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:AJMANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-684-1579
Mailing Address - Street 1:11398 BANDERA RD STE 302
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-6843
Mailing Address - Country:US
Mailing Address - Phone:210-684-1579
Mailing Address - Fax:210-455-2513
Practice Address - Street 1:11212 STATE HWY 151 PLAZA-2
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-7825
Practice Address - Country:US
Practice Address - Phone:210-543-1579
Practice Address - Fax:210-543-1581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-29
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
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