Provider Demographics
NPI:1417495664
Name:QUALITY CARE RX, LLC
Entity Type:Organization
Organization Name:QUALITY CARE RX, LLC
Other - Org Name:QUALITY CARE RX, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NDUKWE
Authorized Official - Middle Name:
Authorized Official - Last Name:ASONYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-707-9575
Mailing Address - Street 1:607 SOUTH WW WHITE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78220
Mailing Address - Country:US
Mailing Address - Phone:210-595-8077
Mailing Address - Fax:
Practice Address - Street 1:607 SOUTH WW WHITE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78220
Practice Address - Country:US
Practice Address - Phone:210-595-8077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-08
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31212333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2167655OtherPK