Provider Demographics
NPI:1396366449
Name:HEALTH GURU RX CORP
Entity Type:Organization
Organization Name:HEALTH GURU RX CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMED SAJID
Authorized Official - Middle Name:SADIQ
Authorized Official - Last Name:SHAIKH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:512-846-6002
Mailing Address - Street 1:409 W FRONT ST STE 100-231
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-4204
Mailing Address - Country:US
Mailing Address - Phone:512-846-6004
Mailing Address - Fax:
Practice Address - Street 1:107A EAST ST
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-4323
Practice Address - Country:US
Practice Address - Phone:512-846-6004
Practice Address - Fax:512-856-9499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX33223OtherTEXAS STATE BOARD LICENSE